JournalTOCs

Health Promotion Practice
Journal Prestige (SJR): 0.596

Citation Impact (citeScore): 1
Number of Followers: 16

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1524-8399 - ISSN (Online) 1552-6372
Published by Sage Publications

[1176 journals]

Milestones and Miles to Go in Latino Health Promotion
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  Authors: Amelie G. Ramirez
  Pages: 793 - 795
  Abstract: Health Promotion Practice, Volume 24, Issue 5, Page 793-795, September 2023.
  
  Citation: Health Promotion Practice
  PubDate: 2023-09-05T07:00:42Z
  DOI: 10.1177/15248399231183393
  Issue No: Vol. 24, No. 5 (2023)
Schools and Wastewater Surveillance: Practical Implications for an
Emerging Technology to Impact Child Health
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  Authors: Gwendolyn Johnson, Angelina Espàrza, Elizabeth Stevenson, Lauren Stadler, Kathy Ensor, Stephen Williams, Komal Sheth, Catherine Johnson, Loren Hopkins
  Abstract: Health Promotion Practice, Ahead of Print.
  Since the start of the COVID-19 pandemic, wastewater surveillance has emerged as a public health tool that supplements traditional surveillance methods used to detect the prevalence of the SARS-CoV-2 virus in communities. In May 2020, the Houston Health Department (HHD) partnered with a coalition of municipal and academic partners to develop a wastewater monitoring and reporting system for the city of Houston, Texas. The HHD subsequently launched a program to conduct targeted wastewater sampling at 52 school sites located in a large, urban school district in Houston. Data generated by this program are shared with school district officials and nurses from participating schools. Although initial feedback from these stakeholders indicated that they considered the wastewater data valuable, the emergency nature of the pandemic prevented a systematic evaluation of the program. To address this gap in knowledge, the HHD and Rice University conducted a study to determine how wastewater data are used to make decisions about COVID-19 prevention and mitigation practices in schools. Our findings indicate that maximizing the utility of wastewater data in the school context will require the development of communication strategies and education efforts tailored to the needs of specific audiences and improving collaboration between local health departments, school districts, and school nurses.
  Citation: Health Promotion Practice
  PubDate: 2023-09-21T05:45:51Z
  DOI: 10.1177/15248399231196857
Engaging Appalachian Youth: Lessons Learned From a Virtual Tobacco
Prevention and Advocacy Training
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  Authors: Courtney Martin, Julia Estes, Melinda Ickes
  Abstract: Health Promotion Practice, Ahead of Print.
  Engaging youth is recommended as a key component of comprehensive tobacco control to bring voice to youth perspective and to connect to community impact. Yet, limited research exists to showcase practical lessons learned in supporting skill development and engagement of youth. This practice note describes how a tailored prevention and advocacy virtual training can serve to engage and empower rural Appalachian high school students to participate in tobacco control efforts. Specifically, we describe the implementation and practical lessons learned from a two-session virtual tobacco prevention and advocacy training led by college facilitators. Participating high school students (N = 20) strongly agreed that tobacco use was a major problem facing their community and that addressing tobacco use should be prioritized. After participating in the training, students’ interpersonal confidence improved and participation in self-reported advocacy increased. Students also liked the virtual platform, interaction with college students, and the opportunity to apply information learned. Youth-focused tailored training promotes skill-building and enhances self-efficacy to engage in tobacco control. Youth engagement should be integral to supporting community health initiatives, including tobacco prevention.
  Citation: Health Promotion Practice
  PubDate: 2023-09-19T10:09:09Z
  DOI: 10.1177/15248399231196858
An Invitation to Imagine: Conclusion of the HPP Series “What Is
Anti-Racism in Health Promotion Practice'”
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  Authors: Wriply Bennet, Keon L. Gilbert, Kathleen Roe
  Abstract: Health Promotion Practice, Ahead of Print.
  Throughout Volume 24 (2023) of Health Promotion Practice, we presented responses to our Call for content addressing the question, “What is Anti-Racism in Health Promotion Practice'” With Editorial Board colleagues, Aditi Srivastav Bussells and Carlos Rodríguez-Diaz, we (Keon L. Gilbert and Kathleen Roe) sought frameworks for action and practical examples that would catalyze, support, and (re)invigorate the field in response to the urgent need to eliminate racism as a cause of inequalities in health. This conversation with artist Wriply Bennett concludes the series. We invite scholars and practitioners to review all 17 contributions to the series and to continue to ask – and address – the question ‘What is anti-racism in our practice, scholarship, and lives'”
  Citation: Health Promotion Practice
  PubDate: 2023-09-15T11:39:56Z
  DOI: 10.1177/15248399231195047
  Issue No: Vol. 24 (2023)
Intergenerationology: The Scientific Study of Circular Movement Between
Generations
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  Authors: Whitney Nesser, Eun-Hye Grace Yi
  Abstract: Health Promotion Practice, Ahead of Print.
  In this article, we propose a new term, “intergenerationology.” Intergenerationology is proposed as a unified term to describe the numerous research and practice models concerning many aspects of circular movement between generations. We define the term intergenerational, with historical context related to research, practice, and policy in the social, behavioral, and health sciences. We also describe how different disciplines have interacted with regard to generations from different yet complementary points of view. Having the term intergenerationology will (a) enable the acceleration and unification of intergenerational studies and practice across disciplines by promoting easy communication among disciplines, (b) encourage more research from diverse science disciplines by giving a name to a popular area of study within them, and (c) provide a recognized term for researchers and practitioners to define their specific teaching, practice, and research interests.
  Citation: Health Promotion Practice
  PubDate: 2023-09-13T06:56:47Z
  DOI: 10.1177/15248399231199712
Key Lessons From a Systematic Behavior Change Communication Process Used
in a Pneumonia Prevention Program in Five African Countries
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  Authors: Libertad González Hernández, Selam Jiffaro Seje, Abiyot Mitiku Gosa, Helena Goroi Goro, Lotte Heuberger, Chelsea Giles-Hansen
  Abstract: Health Promotion Practice, Ahead of Print.
  BackgroundA systematic behavior change communication (BCC) process was designed to enable local partners to effectively conduct formative research and develop a comprehensive BCC strategy, as part of a pneumonia prevention and control program implemented from 2017 to 2021 by the Red Cross Red Crescent in Ethiopia, Ivory Coast, Mali, Sudan, and Zambia.MethodsQualitative content analysis was used to identify, categorize, and summarize key results, lessons, and recommendations related to the BCC process from country evaluation data.ResultsKey elements to success of a locally implemented BCC process include: (1) through simple formative research, understanding household decision-making dynamics for timely health seeking and coexistence of modern and traditional medicine; (2) explicitly analyze motivators for uptake of protective behaviors, with strong and deliberate community participation to validate and tailor BCC messages and channels; (3) ensuring that the challenges to access basic services, such as water and sanitation facilities, are adequately addressed as critical enabling factors for behavior change. Other implications include a need for innovative solutions to physical and economic barriers in areas where large distances, lack of transportation, or cost hinder caregivers seeking care for sick children.ConclusionsCommunity health programs that apply a BCC process through local partners can be effective in achieving behavioral outcomes. Participatory planning and involvement of the community in iterative rounds of validation improved the relevance, appropriateness, and impact. Further research is needed to determine the effectiveness of different communication methods and sustained impact on health outcomes.
  Citation: Health Promotion Practice
  PubDate: 2023-09-13T06:54:17Z
  DOI: 10.1177/15248399231198793
Supporting Diverse Family Caregivers: Key Stakeholder Perspectives
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  Authors: Pamela Nadash, Shan Qu, Eileen J. Tell
  Abstract: Health Promotion Practice, Ahead of Print.
  This study aimed to understand the perspectives of key stakeholders regarding strategies for better supporting culturally and ethnically diverse family caregivers, aiming to incorporate them into the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Advisory Council’s proposed National Strategy. The Strategy, published in 2022, identified priority actions to support the growing population of people providing unpaid care to people of all ages with disabilities, with a goal of improving the health and well-being of both the family caregiver and the person receiving support. Researchers conducted extensive outreach to purposively diverse stakeholder organizations, using six stakeholder strategy sessions with representatives from 42 groups in December 2020 to identify preliminary themes. During July–October 2021, 17 key informant interviews and 16 stakeholder listening sessions were held, involving 103 different organizations. Qualitative data analysis using an inductive approach was used to identify key themes. A significant issue for diverse caregivers is widespread lack of self-identification as caregivers, which is tied to a lack of awareness of potentially helpful services and supports; culturally appropriate outreach is critical to ensure access to services, as well as access to centralized resources and funding for community- and faith-based organizations. A community health worker model was recommended. Tailored activities, involving trusted community- and faith-based groups, as well as investments in caregiver- and culturally-specific supports, are critical for reaching the diverse family caregivers who most need supports. Raising awareness of caregiving among and taking advantage of the expertise of professionals working with diverse communities is also crucial.
  Citation: Health Promotion Practice
  PubDate: 2023-09-11T09:24:18Z
  DOI: 10.1177/15248399231196854
Substance Use and Mental Health Screening Within an Emergency
Department-Based HIV Screening Program: Outcomes From 1 Year of
Implementation
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  Authors: Jennifer L. Brown, Nicole K. Gause, Robert Braun, Brittany Punches, David Spatholt, T. Dylanne Twitty, Joel G. Sprunger, Michael S. Lyons
  Abstract: Health Promotion Practice, Ahead of Print.
  IntroductionThe emergency department (ED) may be an optimal setting to screen for substance use disorders (SUDs) and co-occurring psychiatric disorders (CODs). We report on the frequency of problematic substance use and comorbid elevated mental health symptoms detected during a 1-year implementation period of an ED-based SUD/COD screening approach within an established ED HIV screening program.MethodsPatients (N = 1,924) were approached by dedicated HIV screening staff in an urban, Midwestern ED. Patients first completed measures assessing problematic alcohol (Alcohol Use Disorder Identification Test-Concise [AUDIT-C]) and substance use across 10 categories of substances (National Institute on Drug Abuse–Modified Alcohol, Smoking, and Substance Involvement Screening Test [NIDA-Modified ASSIST]). Patients with positive alcohol and/or substance use screens completed measures assessing symptoms of depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and post-traumatic stress disorder (PTSD) (PTSD Checklist-Civilian [PCL-C]).ResultsPatients were predominantly male (60.3%) with a mean age of 38.1 years (SD = 13.0); most identified as White (50.8%) or Black (44.8%). A majority (58.5%) had a positive screen for problematic alcohol and/or other substance use. Of those with a positive substance use screen (n = 1,126), 47.0% had a positive screen on one or more of the mental health measures with 32.1% endorsing elevated depressive symptoms, 29.6% endorsing elevated PTSD-related symptoms, and 28.5% endorsing elevated anxiety symptoms.ConclusionsAmong those receiving ED HIV screening, a majority endorsed problematic alcohol and/or other substance use and co-occurring elevated mental health symptoms. Substance use and mental health screening programs that can be integrated within other ED preventive services may enhance the identification of individuals in need of further assessment, referral, or linkage to substance use treatment services.
  Citation: Health Promotion Practice
  PubDate: 2023-08-31T12:55:37Z
  DOI: 10.1177/15248399231193005
The C-CAP Process: A Comprehensive Approach to Community Resource Mapping
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  Authors: Amy Mowle, Bojana Klepac, Therese Riley, Melinda Craike
  Abstract: Health Promotion Practice, Ahead of Print.
  IntroductionPlace-based systems change approaches are gaining popularity to address the complex problems associated with locational disadvantage. An important stage of place-based systems change involves understanding the context that surrounds (re)produces a target problem. Community resource mapping can be used to establish the context and identify the strengths of a community that might be leveraged through systems change efforts. Approaches to community resource mapping draw on a range of philosophical assumptions and methodological frameworks. However, comprehensive, practical guidance for researchers and practitioners to conduct community resource mapping is scarce.MethodDrawing on the learnings from a literature review, scoping workshops, and reflective practice sessions, we developed a flexible, methodologically robust process called the Contextualize, Collect, Analyze, and Present (C-CAP) process: a four-phase approach to preparing for, conducting, and reporting on community resource mapping. The C-CAP process was co-developed by researchers and practitioners and was tested and refined in two different communities.ResultsThe C-CAP process provides robust guidance for conducting and reporting on a community resource mapping project. The C-CAP process can be applied by public health practitioners and researchers and adapted for use across different communities, problems, and target groups. We encourage others guided by differing theoretical perspectives to apply C-CAP and share the learnings.ConclusionApplication of the C-CAP process has the potential to improve the comparability and comprehensiveness of findings from community resource mapping projects and avoids duplication of effort by reducing the need to design new processes for each new community resource mapping activity.
  Citation: Health Promotion Practice
  PubDate: 2023-08-31T10:31:09Z
  DOI: 10.1177/15248399231193696
Qualitative Assessment of Key Implementation Factors in a Faith-Based
Response to Intimate Partner Violence
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  Authors: Beata Debinski, Mark Bittle, Caitlin E. Kennedy, Vanya Jones, Andrea Carlson Gielen
  Abstract: Health Promotion Practice, Ahead of Print.
  BackgroundFaith-based organizations (FBOs) have a scant history in the literature of implementing intimate partner violence (IPV) initiatives, though many members of faith communities consider it an important issue. Furthermore, the limited studies on this topic have not explored organizational factors that are important in the implementation of such efforts.PurposeTo investigate factors that influence the implementation of IPV prevention and response by one Catholic organization at both diocesan and parish levels.MethodsWe conducted sixteen semi-structured interviews with members of Archdiocese of Chicago Domestic Violence Outreach (ACDVO) leadership. Using deductive content analysis, we drew on all 14 constructs and sub-constructs from the inner setting domain of the Consolidated Framework for Implementation Research (CFIR) for coding transcripts and characterizing factors influencing implementation success.ResultsSeven CFIR constructs were useful in identifying factors that influenced implementation success of ACDVO. At the diocesan level, the organization’s leadership structure, their driven culture, and in-kind available resources propelled their work. At the level of parish ministries, successful implementation was facilitated by networking and communication among parishes. At the diocesan-level, access to knowledge and information through ACDVO’s Parish Support Committee, compatibility with parish values, leadership engagement, and available resources from parishes supported implementation.ConclusionsWe identified modifiable and reproducible inner setting factors that influence implementation of a Catholic IPV initiative at the diocesan-level and support parish ministries in their local activities. Future work should validate these findings in other dioceses and examine non-Catholic FBO settings.
  Citation: Health Promotion Practice
  PubDate: 2023-08-31T06:43:27Z
  DOI: 10.1177/15248399231193693
Local Health Department Values and Organizational Authorities Guiding
Cross-Sector Work During COVID-19
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  Authors: Karl Johnson, Caitlin B. Biddell, Katherine Gora Combs, John Wiesman, Monica Valdes Lupi, Kristen Hassmiller Lich
  Abstract: Health Promotion Practice, Ahead of Print.
  ObjectiveThe COVID-19 pandemic highlighted the role that local health departments (LHDs) have in cross sector can address alone, including the work of value alignment and the strategic use of organizational authorities. The practices by which LHDs used their authorities to conduct cross-sector work during the pandemic need exploration.MethodWe conducted semi-structured interviews with 19 public health leaders from metropolitan LHDs across the United States. Our interview guide assessed the values that LHD leadership prioritized in their cross-sector work as well as the range of organizational authorities they leveraged to influence external decision-making in other sectors.ResultsWe found that LHDs approached cross-sector work by leaning on diverse values and authorities, each with unique implications for their work. The LHDs emphasized their approach to value alignment on a sector-by-sector basis, strategically using diverse organizational authorities—economic, political, moral, scientific, and logistical. While each authority and value we assessed was present across all interviewees, how each shaped action varied. Internally, LHDs emphasized certain authorities more than others to the degree that they more closely aligned with prioritized core values.ConclusionOur findings highlight the ongoing need for LHD leadership to improve their ability to effectively communicate public health values and the unique authorities by which health-supporting work can be facilitated, including how this message must be adapted, depending on the specific sectors with which the LHD needs to partner and the governance arrangement in which the LHD is situated.
  Citation: Health Promotion Practice
  PubDate: 2023-08-31T06:40:49Z
  DOI: 10.1177/15248399231192989
Mandating COVID-19 Vaccination on Campus: A Qualitative Analysis of a
Cross-Sectional Study of California College Students
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  Authors: Anji Buckner-Capone, Marcelle Dougan
  Abstract: Health Promotion Practice, Ahead of Print.
  The purpose of this study was to examine college student perceptions related to institutional vaccine mandates. We utilized qualitative data (n = 2,212) from five open-ended questions in a cross-sectional study of students enrolled or intending to enroll in an institute of higher education in California in fall 2021. Data were collected between June and August 2021. Thematic analysis was employed to analyze student beliefs, and four themes were developed from the data: (1) Polarizing views and language; (2) deciding who to trust; (3) conveying rights and risk; and (4) staying focused on education. The themes represented vaccinated and nonvaccinated student perspectives, capturing views about trust, rights, and risk. Many responses were polarizing and included language that was emotional and political. Despite the range of responses, most students expressed appreciation and approval of the vaccination mandate on college campuses. Findings illustrate the important contributions of qualitative research and suggest opportunities for public health practitioners to lead and engage in critical dialogue about science and public health practices as we aim to promote public perceptions of vaccination programs and health promotion practice.
  Citation: Health Promotion Practice
  PubDate: 2023-08-24T08:09:48Z
  DOI: 10.1177/15248399231192997
Laundromats: Community-Based Partnerships to Increase Reproductive Health
Literacy Outreach
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  Authors: Roxanne Mirabal-Beltran, Kelsey Rondini, Laura Linnan
  Abstract: Health Promotion Practice, Ahead of Print.
  Laundromats are a regularly visited, highly localized community venue, especially in underserved communities. Few health literacy and health-promotion programs have taken place in laundromats, and there have been no efforts to apply community-based participatory research approaches in this setting. Literacy programs and cancer-prevention initiatives have been held in laundromats, but little data exist on the empirical outcomes of such initiatives or whether the programs have been fashioned as a collaboration between community and researchers. In this paper, we present a brief overview of literacy and cancer-prevention initiatives that have taken place in laundromats and introduce our Wash and Spin Toward Health/Washington Avanzando la Salud Hispana (W.A.S.H.) project. We describe how we applied community-based participatory research principles to launch this effort and identify both benefits and challenges of this approach. We hope this project will stimulate greater interest in laundromat settings for outreach and education efforts, especially those addressing disparities in health literacy and access.
  Citation: Health Promotion Practice
  PubDate: 2023-08-22T07:10:38Z
  DOI: 10.1177/15248399231193004
Virtual Implementation of a Photovoice Project With Youth in Baltimore
During the COVID-19 Pandemic
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  Authors: Ohemaa B. Poku, Bianca D. Smith, Abigail M. Pollock, Breyanna Dabney, Shan Wallace, Subira Brown, Eugenia Eng, Tamar Mendelson, Haneefa T. Saleem, Sabriya L. Linton
  Abstract: Health Promotion Practice, Ahead of Print.
  This article describes the virtual implementation of Photovoice activities conducted as part of a project that sought to gather youths’ perspectives on neighborhood and housing conditions, community redevelopment, and health and well-being in Baltimore. We discuss the original in-person design and how activities were implemented virtually, in light of coronavirus disease 2019 (COVID-19) physical distancing guidelines. Challenges to virtual implementation included establishing rapport with youth and families during recruitment and data collection, encouraging active participation during discussion sessions, and varying technological skills among youth. Facilitators of virtual implementation included partnering with a community organization, piloting virtual sessions to assess participant’s technology skills, and providing various ways for youth to participate during discussion sessions, engage in group activities, and receive hands-on instruction. This article showcases the ways in which virtual implementation of Photovoice activities can be successfully implemented with youth and provides recommendations for future Photovoice projects that include virtual activities.
  Citation: Health Promotion Practice
  PubDate: 2023-08-22T07:05:07Z
  DOI: 10.1177/15248399231193002
Braiding the Healing Gifts of Photovoice for Social Change: The Means Are
Ends in the Making
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  Authors: Mary Ann Burris, Robin A. Evans-Agnew, Robert W. Strack
  Abstract: Health Promotion Practice, Ahead of Print.
  Photovoice is an important participatory action method for motivating social change. The potential for this change within the processes of the method remains under-explored. We present the voice and perspectives of three health promotion practitioners who have important connections to photovoice: a grandmother and co-founder of the method, a nurse from Wales, and an early adopter seeking change. Through braided storytelling, the voices describe their history with photovoice and how their relationship to the method has changed over time, arguing ultimately that in photovoice the means are as important as the ends for advancing relations with others, understanding and working with power, and realizing the gifts the processes bring.
  Citation: Health Promotion Practice
  PubDate: 2023-08-22T07:01:58Z
  DOI: 10.1177/15248399231192993
Period Poverty: an Epidemiologic and Biopsychosocial Analysis
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  Authors: Allison R. Casola, Kierstin Luber, Amy Henderson Riley
  Abstract: Health Promotion Practice, Ahead of Print.
  In the United States, approximately one in five persons experience period poverty, defined as the inability to obtain resources needed for healthy, safe, and dignified menstrual management. Limited access to an inadequate number of menstrual supplies may lead to longer-than-recommended use, which can increase skin chafing, disruption of vaginal flora, and intravaginal toxin overgrowth. However, period poverty goes beyond simply having enough menstrual products and can encompass the embarrassment, stigma, shame, and barriers in conversation surrounding menstruation. Discussion and critical examination of the multilayered attributes surrounding period poverty have been intermittent in academic literature, particularly from a domestic lens. Thus, this narrative review and theoretical analysis aimed to describe the epidemiology of period poverty and analyze its biological, socio-emotional, and societal implications. We applied a descriptive epidemiology approach of person, place, and time, and employed a social-ecological lens to examine risk factors. Our findings describe the incidence, distribution, and possible ways to alleviate period poverty. Practitioners, medical providers, and public health professionals may have limited knowledge of period poverty, what it entails, and who it impacts, but they have great potential to address it and associated menstrual inequities in their work. With its widespread implications for psychosocial and community-level health, this phenomenon needs urgent attention to promote menstrual equity as an issue of human rights and social justice. We conclude with research and policy recommendations for alleviating period poverty.
  Citation: Health Promotion Practice
  PubDate: 2023-08-22T06:58:39Z
  DOI: 10.1177/15248399231192998
Attitudes Toward Injection Practices Among People Who Inject Drugs
Utilizing Medical Services: Opportunities for Harm Reduction Counseling in
Health Care Settings
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  Authors: Dinah Applewhite, Susan Regan, Karen Donelan, Wendy L. Macias-Konstantopoulos, Laura G. Kehoe, Dawn Williamson, Sarah E. Wakeman
  Abstract: Health Promotion Practice, Ahead of Print.
  Hospitals are an important setting to provide harm reduction services to people who inject drugs (PWID). This study aimed to characterize PWID’s injection practices, the perceived risk and benefits of those practices, and the immediate IDU risk environment among individuals seeking medical care. Surveys were administered to 120 PWID seeking medical services at an urban hospital. Poisson regression was used to examine the effect of perceived risk or importance of injection practices on the rate of engaging in those practices. The mean participant reported “often” reusing syringes and “occasionally” cleaning their hands or skin prior to injection. 78% of participants reported that syringes were extremely risky to share, which was associated with lower likelihood of sharing them (ARR: 0.59; 95% CI: 0.36-0.95). 38% of participants reported it was extremely important to use a new syringe for each injection, and these participants were more likely to report never reusing syringes>5 times (ARR: 1.62, 95% CI: 1.11-2.35). Other factors that may influence injection practices—including fear of arrest, withdrawal, lack of access to supplies, and injecting outdoors—were common among participants. In conclusion, practices that place PWID at risk of injury and infection are common, and risk-benefit perception is associated with some, but not all, injection practices. Injecting in challenging environments and conditions is common. Therefore, harm reduction counseling in medical settings must be accompanied by other strategies to reduce risk, including facilitating access to supplies. Ultimately, structural interventions, such as affordable housing, are needed to address the risk environment.
  Citation: Health Promotion Practice
  PubDate: 2023-08-17T08:50:59Z
  DOI: 10.1177/15248399231192996
Bridges to Elders: A Program to Improve Outcomes for Older Women
Experiencing Homelessness
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  Authors: Kimberlee Flike, Roseanna H. Means, Jiyin Chou, Ling Shi, Laura L. Hayman
  Abstract: Health Promotion Practice, Ahead of Print.
  Homelessness among older individuals is increasing and women experiencing homelessness have been previously shown to have poorer health outcomes than their male counterparts. To address these concerns, the Bridges to Elders (BTE) program was developed to improve health and social outcomes for older women experiencing or at risk for homelessness. BTE consisted of a nurse practitioner (NP) and community health worker (CHW) dyad who provided intensive case management services for women 55+ with housing instability. This evaluation used a pretest/posttest design to examine three main outcomes from BTE: change in housing status, enrollment with a primary care provider (PCP), and diagnosis of uncontrolled chronic condition. The sample included 96 BTE participants enrolled from January 2017 to December 2018. The average age of participants was 66 years and had a mean BTE enrollment time of 7.6 months. Statistically significant improvements were achieved in all three outcomes measured: 17% (p < .009) increase in stable housing, 35% (p < .001) increase in PCP enrollment, and 47% (p < .001) decrease in the diagnosis of an uncontrolled chronic condition. The results indicated an NP/CHW dyad improved housing status, primary care access, and targeted health outcomes for older women who are experiencing or at risk for homelessness. Future studies examining the impact of NP/CHW dyads on additional social determinants of health and their impact on health outcomes are recommended.
  Citation: Health Promotion Practice
  PubDate: 2023-08-17T08:48:40Z
  DOI: 10.1177/15248399231192992
Vaping—Know the Truth: Evaluation of an Online Vaping Prevention
Curriculum
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  Authors: Elizabeth C. Hair, Shreya Tulsiani, Madeleine Aseltine, Elizabeth K. Do, Rebecca Lien, Daniel Zapp, Molly Green, Donna Vallone
  Abstract: Health Promotion Practice, Ahead of Print.
  BackgroundUnacceptably high levels of e-cigarette use among youth paired with growing research about the dangers of vaping demonstrate a critical need to develop interventions that educate young people to reject e-cigarette use and promote cessation for current users. Vaping: Know the Truth (VKT) is a free digital learning experience prioritizing middle and high school students that aims to improve students’ knowledge about the dangers of using e-cigarettes and provide quitting resources for those who already vape. The current study was designed to evaluate whether students receiving the curriculum increased knowledge of the dangers of vaping.MethodsThe outcome measures were calculated as the change in the number of correct responses from the pre- to post-module assessments among middle and high school students who completed four modules of the VKT curriculum (N = 103,522). Linear regression was performed to determine the association between the student’s pre-module assessment score and the knowledge change score after completion of the four modules.ResultsStudents’ e-cigarette knowledge significantly improved by an average of 3.24 points (SD: 3.54), following implementation of the VKT curriculum. This indicates that participants answered more than 3 additional questions correctly, on average, after the intervention.ConclusionFindings demonstrate that the Vaping: Know the Truth curriculum is an effective resource for increasing knowledge among youth about the harms associated with e-cigarette use. Further research is needed to evaluate whether the intervention is associated with behavioral outcomes over time.
  Citation: Health Promotion Practice
  PubDate: 2023-08-07T07:16:27Z
  DOI: 10.1177/15248399231191099
Operationalizing the Centers for Disease Control and Prevention’s
Vaccinate With Confidence Framework During the COVID-19 Emergency Response
in the United States
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  Authors: Kathleen Holmes, Margaret Gutierrez-Nkomo, John Donovan, Brian J. Manns, Stephanie Griswold, Regina Edwards, Stephen A. Flores, Amy Parker Fiebelkorn
  Abstract: Health Promotion Practice, Ahead of Print.
  In December 2020, 11 months after identifying the first laboratory-confirmed case of COVID-19 in the United States, the U.S. Food and Drug Administration authorized emergency use of two COVID-19 vaccines. To prepare the public for a large-scale vaccination campaign and build confidence in COVID-19 vaccines, the U.S. Centers for Disease Control and Prevention (CDC) funded more than 200 partners and developed a national Vaccinate with Confidence (VwC) COVID-19 framework to support Americans in their decision to get vaccinated. The evolving nature of the pandemic and highly variable confidence in vaccines across populations has resulted in many unique complexities and challenges to reaching universally high vaccination coverage. Here, we describe how 23 professional health associations and national partner organizations, focused solely on building vaccine confidence, operationalized CDC’s VwC COVID-19 framework from February 2021 to March 2022. Capturing how partners deployed and adapted their activities to meet a shifting pandemic landscape, which began with high demand for vaccines that waned over time, is an important first step to understanding how this new strategy was utilized and could be implemented for future surges in COVID-19 cases and other routine immunization efforts. Going forward, evaluation of partner activities should be prioritized to capture learnings and assess VwC program effectiveness.
  Citation: Health Promotion Practice
  PubDate: 2023-08-01T05:14:56Z
  DOI: 10.1177/15248399231188106
Sleeping Healthy, Living Healthy: Using Iterative, Participatory Processes
to Develop and Adapt an Integrated Sleep Hygiene/Mind-Body Integrative
Health Intervention for Urban Adolescents
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  Authors: Samantha Garbers, April J. Ancheta, Melanie A. Gold, Malia Maier, Jean-Marie Bruzzese
  Abstract: Health Promotion Practice, Ahead of Print.
  Racial and ethnic minority adolescents living in urban settings experience sleep disparities. Few interventions have been developed to address these disparities. Guided by principles of participatory design and inclusion, our team developed a novel intervention that combined sleep hygiene education with mind-body integrative health (MBIH) practices to improve sleep quality among adolescents in New York City. The goal of this article is to describe our iterative development and design process, the final product, and future directions. Our participatory approach incorporated information from formative work with adolescents having lived experience, practitioners, and syntheses of published literature. The final intervention—Sleeping Healthy, Living Healthy—consists of six, 40-minute group sessions and one 20-minute individual session designed for high school students. Each session has a set of learning objectives, combining instruction, group activities, and discussions on sleep hygiene and MBIH topics. Our manualized intervention includes handouts created by a graphic design team that served as a review and reminder for home practice. We describe intervention implementation to two unique cohorts and detail our methods used to fine-tune the intervention between cohorts. Our partnership with and insights from both adolescents and practitioners serve as a guide for researchers aiming to use participatory methods to develop interventions to decrease health disparities in specific populations.
  Citation: Health Promotion Practice
  PubDate: 2023-07-26T06:42:59Z
  DOI: 10.1177/15248399231184453
A Community-Defined Approach to Address Trauma Among Cambodian Immigrants
and Refugees
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  Authors: Parichart Sabado, Kimthai Kuoch, Susana Sngiem, Vattana Peong, Ladine Chan, Chan Hopson, Tongratha Veng, Gary Colfax, Lavyn Tham, Amina Sen-Matthews, Virak Ung, Pearun Tieng, Crystal Siphan, Jessica Dance, Kyle Change, Jasmine Doxey, Jefferson Wood, Laura D’Anna
  Abstract: Health Promotion Practice, Ahead of Print.
  Asian American and Pacific Islanders are one of the fastest growing and most diverse groups in the United States. Yet, they are often aggregated as a single group, masking within-group differences in rates of disease and demographic characteristics commonly associated with elevated health risk. While more than four decades have passed since the Khmer Rouge genocide, Cambodians continue to experience trauma-related psychiatric disorders, including post-traumatic stress disorder and major depression. Funded by the California Department of Public Health Office of Health Equity, the Community Wellness Program (CWP) aimed to reduce mental health disparities among Cambodians in Long Beach and Santa Ana, California, using community-defined approaches. The 6-month program comprised community outreach, educational workshops, strengths-based case management, and social and spiritual activities. Our study aimed to examine the effects of the CWP on trauma symptoms. Program evaluation followed an incomplete stepped wedge waitlist design with two study arms. A linear mixed models analysis revealed that participants reported fewer trauma symptoms as a result of participation in the CWP and that participants experienced fewer symptoms over time. This is an especially important finding, as trauma can lead to long-term individual health effects and to social and health repercussions on an entire cultural group by way of intergenerational trauma. As the number of refugees and displaced individuals continues to grow, there is an urgent need for programs such as the CWP to prevent the lasting effects of trauma.
  Citation: Health Promotion Practice
  PubDate: 2023-07-24T06:29:18Z
  DOI: 10.1177/15248399231184450
Impacts of the COVID-19 Public Health Crisis on Caring for Sex-Trafficked
Persons
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  Authors: Frances Recknor, C. Emma Kelly, Danielle Jacobson, Frances Montemurro, Rhonelle Bruder, Robin Mason, Janice Du Mont
  Abstract: Health Promotion Practice, Ahead of Print.
  BackgroundSex trafficking of persons, a pervasive public health issue disproportionately affecting the most marginalized within society, often leads to health as well as social consequences. Social service provision to meet the resulting needs is critical, however, little is known about the current pandemic’s impact on providers’ capacity to deliver requisite care.MethodTo examine social service providers’ perspectives of care provision for domestically sex-trafficked persons in Ontario, Canada, during the COVID-19 pandemic, we conducted semi-structured interviews with 15 providers and analyzed these using Braun and Clarke’s analytic framework.ResultsImpacts of the COVID-19 pandemic on social service care provision were connected to individuals’ increased vulnerability to trafficking, difficulties safely and effectively providing services to sex-trafficked persons amid pandemic restrictions, and reduction in in-person educational activities to improve providers’ capacity to serve this client population. Securing safe shelter was particularly difficult and inappropriate placements could at times lead to further trafficking.ConclusionThe pandemic created novel barriers to supporting sex-trafficked persons; managing these sometimes led to new and complex issues. Future efforts should focus on developing constructive strategies to support sex-trafficked persons’ unique needs during public health crises.
  Citation: Health Promotion Practice
  PubDate: 2023-07-21T09:56:37Z
  DOI: 10.1177/15248399231186639
Barriers and Facilitators to Integrating Depression Treatment Within a TB
Program and Primary Care in Brazil
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  Authors: Annika Claire Sweetland, Claudio Gruber Mann, Maria Jose Fernandes, Fatima Virginia Siqueira de Menezes Silva, Camila Matsuzaka, Maria Cavalcanti, Sandra Fortes, Afranio Kritski, Austin Y. Su, Julio Cesar Ambrosio, Bianca Kann, Milton L. Wainberg
  Abstract: Health Promotion Practice, Ahead of Print.
  Tuberculosis (TB) and depression is common and is associated with poor TB outcomes. The World Health Organization End TB Strategy explicitly calls for the integration of TB and mental health services. Interpersonal Counseling (IPC) is a brief evidence-based treatment for depression that can be delivered by non-mental health specialists with expert supervision. The goal of this study was to explore potential barriers and facilitators to training non-specialist providers to deliver IPC within the TB Control Program and primary care in Itaboraí, Rio de Janeiro state. Data collection consisted of six focus groups (n = 42) with health professionals (n = 29), program coordinators (n = 7), and persons with TB (n = 6). We used open coding to analyze the data, followed by deductive coding using the Chaudoir multi-level framework for implementation outcomes. The main structural barriers identified were poverty, limited access to treatment, political instability, violence, and social stigma. Organizational barriers included an overburdened and under-resourced health system with high staff turnover. Despite high levels of stress and burnout among health professionals, several provider-level facilitators emerged including a high receptivity to, and demand for, mental health training; strong community relationships through the community health workers; and overall acceptance of IPC delivered by any type of health provider. Patients were also receptive to IPC being delivered by any type of professional. No intervention-specific barriers or facilitators were identified. Despite many challenges, integrating depression treatment into primary care in Itaboraí using IPC was perceived as acceptable, feasible, and desirable.
  Citation: Health Promotion Practice
  PubDate: 2023-07-21T09:53:28Z
  DOI: 10.1177/15248399231183400
COVID-19 Health Education Activities: An Analysis of a National Sample of
Certified Health Educations Specialists (CHES®/MCHES®) in Response to
the Global Pandemic
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  Authors: Beth H. Chaney, Michael L. Stellefson, Melissa Opp, Marianne Allard, J. Don Chaney, Kylie Lovett
  Abstract: Health Promotion Practice, Ahead of Print.
  The National Commission of Health Education Credentialing, Inc. (NCHEC) created the Category 1 COVID-19 Claim Form Opportunity to document how Certified Health Education Specialists (CHES®) and Master Certified Health Education Specialists (MCHES®) assisted communities during the COVID-19 pandemic. Using data submitted by CHES®/MCHES® (n = 3,098 claim forms), the purpose of this study was to (a) describe the settings where CHES® and MCHES® completed their pandemic work and (b) assess differences in the type of pandemic work completed by CHES® compared with MCHES® based on specific Areas of Responsibility (AOR) for Health Education Specialists. Findings showed that CHES® and MCHES® engaged in seven AOR during the pandemic, with the largest proportion of CHES® (n = 859; 33%) and MCHES® (n = 105; 21.9%, documenting COVID-19-related activities in health departments. CHES® reported higher engagement than MCHES® in activities such as COVID-19 reporting/tracking, χ2 (1, N = 3,098) = 27.3, p < .001; outbreak response, χ2 (1, N = 3,098) = 4.3, p = .039; and vaccination, χ2 (1, N = 3,098) = 5.2, p = .023. Conversely, MCHES® reported higher participation than CHES® in screening/testing, χ2 (1, N = 3,098) = 174.2, p < .001; administration of budgets/operations, χ2 (1, N = 3,098) = 30.1, p < .001; and adapting educational activities at college/universities, χ2 (1, N = 3,098) = 46.1, p < .001. CHES® were more likely than MCHES® to indicate working in all AOR except for Area 2—Plan Health Education/Promotion. Results support that employer-verified health education skills in all AOR were transferable during COVID-19, especially for CHES® employed within state/county health departments.
  Citation: Health Promotion Practice
  PubDate: 2023-07-19T10:17:46Z
  DOI: 10.1177/15248399231184447
Defining “Arts Participation” for Public Health Research
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  Authors: Jill Sonke, Alexandra K. Rodriguez, Aaron Colverson, Seher Akram, Nicole Morgan, Donna Hancox, Caroline Wagner-Jacobson, Virginia Pesata
  Abstract: Health Promotion Practice, Ahead of Print.
  Arts participation has been linked to positive health outcomes around the globe. As more research is taking place on this topic, there is heightened need for definitions for the complex concepts involved. While significant work to define “arts participation” has taken place in the arts sector, less work has been undertaken for the purpose of researching the arts in public health. This study developed a definition for “arts participation” to guide a national arts in public health research agenda and to advance and make more inclusive previous work to define the term. A convergent mixed-methods study design with sequential elements was used to iteratively develop a definition that integrated the perspectives of field experts as well as the general public. Literature review was followed by four iterative phases of data collection, analysis, and integration, and a proposed definition was iteratively revised at each stage. The final definition includes modes, or ways, in which people engage with the arts, and includes examples of various art forms intended to frame arts participation broadly and inclusively. This definition has the potential to help advance the quality and precision of research aimed at evaluating relationships between arts participation and health, as well as outcomes of arts-based health programs and interventions in communities. With its more inclusive framing than previous definitions, it can also help guide the development of more inclusive search strategies for evidence synthesis in this rapidly growing arena and assist researchers in developing more effective survey questions and instruments.
  Citation: Health Promotion Practice
  PubDate: 2023-07-17T09:18:33Z
  DOI: 10.1177/15248399231183388
Special Projects of National Significance Curing Hepatitis C (HCV) Among
People of Color Living With HIV Initiative: Improving Linkage to and
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  Authors: Waridibo E. Allison
  Abstract: Health Promotion Practice, Ahead of Print.
  
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T06:00:43Z
  DOI: 10.1177/15248399231169785
Hepatitis C Knowledge, Attitudes, and Perceptions Among People With HIV in
South Texas
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  Authors: Waridibo E. Allison, Aro N. Choi, Keito Kawasaki, Anmol Desai, Joel Tsevat, Trisha V. Melhado
  Abstract: Health Promotion Practice, Ahead of Print.
  Direct-acting antivirals are overwhelmingly effective in curing hepatitis C (HCV). Barriers to HCV treatment exist for those co-infected with both HIV and HCV. Southern states represent the epicenter of the HIV epidemic in the United States. This study assessed HCV knowledge, attitudes, and perceptions in 318 co-infected individuals attending Ryan White HIV/AIDS Program (RWHAP) clinics in three South Texas cities. Two groups were compared, those tested for HCV and aware of their results (Group 1) and those uncertain if they were tested or tested and unaware of their results (Group 2). HCV knowledge was poor overall. Group 1 had a significantly higher mean HCV knowledge score than Group 2 by t-test (48.6 vs. 38.8; p < .01), but not by multivariable linear regression (p=.14). Factors predictive of greater HCV knowledge included self-identification as lesbian, gay, bisexual, transgender, queer and post high school educational attainment. Significantly more in Group 1 compared with Group 2 agreed that HCV medications would keep a person healthier for longer. Spanish speakers were more likely to disagree with a statement that people of color receive the same treatment for hepatitis C as white people. Study limitations identified include poor generalizability to people with HIV (PWH) receiving care in non-RWHAP settings and rural communities. Despite limitations, this study augments the paucity of information about knowledge, attitudes, and perceptions of HCV in PWH and can inform interventions to combat barriers to HCV treatment and to maximize opportunities for HCV screening, diagnosis, and linkage to curative care.
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T05:30:01Z
  DOI: 10.1177/15248399231169924
Accessing Care During the COVID-19 Pandemic Using Telemedicine:
Perspectives From People With HIV
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  Authors: Waridibo E. Allison, Aro N. Choi, Keito Kawasaki, Anmol Desai, Trisha V. Melhado
  Abstract: Health Promotion Practice, Ahead of Print.
  The COVID-19 pandemic has resulted in a steep increase in telemedicine implementation and use. Data are lacking on telemedicine use in marginalized and underserved groups including people with HIV (PWH). The Ryan White HIV/AIDS Program (RWHAP) is the largest single provider of HIV care in the United States (U.S.) and the southern part of the country remains the epicenter of the HIV epidemic. This study recruited PWH from RWHAP clinics across South Texas. To ascertain their perspectives on utilizing telemedicine for HIV care during the COVID-19 pandemic, a survey instrument derived from validated instruments was used. Descriptive statistics were used for client characteristics, quality of telemedicine care, and COVID-19 impact. Wilcoxon Rank Sum and Kruskal–Wallis tests were assessed associations of telemedicine care quality and COVID-19 impact between client groups. Among 246 eligible PWH, 122 clients completed the survey with a response rate of 50%. Clients were predominantly Hispanic males. Significant differences in perception of telemedicine care and the impact of COVID-19 by gender, age, language, and race/ethnicity were observed. Older PWHIV used telemedicine more than younger clients (p = .01). English speakers indicated more impact of the COVID-19 pandemic on daily life than Spanish speakers (p = .02). Worry about the pandemic was most evident among non-Hispanic Black and Hispanic PWH (p = .03). Overall, telemedicine was found to be a favorable and acceptable mechanism of HIV care delivery by PWH in a Southern state during the COVID-19 pandemic.
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T05:00:23Z
  DOI: 10.1177/15248399231169925
Mitigating the HIV and Viral Hepatitis Workforce Crisis Through
Development of an HIV/Hepatitis C Coinfection Mobile Application
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  Authors: Waridibo E. Allison, Shreya Prasanna, Aro N. Choi, Keito Kawasaki, Anmol Desai, Trisha V. Melhado
  Abstract: Health Promotion Practice, Ahead of Print.
  A decline in the HIV workforce has led to a crisis of insufficient expertise to manage people with HIV (PWH), roughly a quarter of whom are coinfected with hepatitis C. Task shifting to nonspecialist providers can contribute to solving the HIV workforce shortage problem, but nonspecialist providers require sufficient training and support to acquire and retain the necessary knowledge and skills. Digital tools including mobile applications (apps) and telementoring which utilizes telecommunication technology for education and skill acquisition can be used for professional development. Described is the development and dissemination of a mobile app specifically for providers managing HIV/HCV coinfection in the United States. The app, through provider professional development, facilitates access to curative HCV treatment in PWH, encourages integration of HCV care into primary care and contributes to national goals to eliminate HIV and viral hepatitis by 2030.
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T04:01:00Z
  DOI: 10.1177/15248399231169929
Qualitative Evaluation of a Program to Integrate Hepatitis C Care Into HIV
Care Inclusive of Task Shifting to Nonspecialist Providers
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  Authors: Waridibo E. Allison, Anmol Desai, Keito Kawasaki, Aro N. Choi, Raudel Bobadilla, Trisha V. Melhado, Barbara S. Taylor
  Abstract: Health Promotion Practice, Ahead of Print.
  The treatment and cure of hepatitis C (HCV) in people with HIV is particularly important as progression of their liver disease is quicker compared with those who have HCV monoinfection. Innovative approaches are needed to maximize access to curative HCV treatment. Integration of HCV care into HIV primary care with education and support of nonspecialist providers via telementoring offers a solution to specialist workforce shortages. Using focus group qualitative methodology, health care workers’ perspectives regarding this approach, particularly with the Extension for Community Healthcare Outcomes (ECHO) telementoring model, were obtained and are described. Successful integration of HCV care into HIV primary care has demonstrated benefits to patients, including allowing them to remain in their medical home for care. Factors beyond disease that influence their health and wellbeing must also be considered.
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T04:00:01Z
  DOI: 10.1177/15248399231169927
Challenges to Achieving HCV Micro-Elimination in People With HIV in the
United States: Provider Perspectives and the Role of Implicit Bias
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  Authors: Elizabeth DiDomizio, Divya K. Chandra, Lisa Nichols, Merceditas Villanueva, Frederick L. Altice
  Abstract: Health Promotion Practice, Ahead of Print.
  The prevalence of HIV/HCV (hepatitis C virus) co-infection is high particularly in persons who inject drugs (PWID) and is increasing because of the evolving opioid epidemic in the United States. The introduction of effective antiviral medications for HCV has raised the strategic goal of HCV micro-elimination, and efforts to understand the barriers to treatment are critical. In this study, we explored the provider perspective of factors that inhibit HCV micro-elimination efforts in people with HIV (PWH), including the role of implicit bias and related stigma in providers’ health care decision making. We used the mixed-methods approach of nominal group technique (NGT) with 14 participants from 11 different clinics engaged in two virtual focus group sessions (n = 5 and n = 9). Responses from the NGTs were rank ordered during the sessions to identify providers’ perspectives of major barriers and facilitators, then identified possible implicit bias after the NGTs concluded. There were 12 responses given for micro-elimination barriers with the three most prioritized being housing instability, medication nonadherence concerns, and inability to motivate patients. Of these, eight were categorized as potential implicit biases. Among the 14 responses given for facilitators of treatment, the three major solutions included distributive models of care, improved provider knowledge, and increased patient engagement. Although the solutions offered were insightful, there was consensus that the individual lives of patients were the root cause of most barriers to care. We recommend further research on behavioral design interventions that promote patients’ involvement in decision making and focus on patients’ eligibility criteria for HCV treatment as opposed to providers’ perceived barriers to treatment.
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T03:30:03Z
  DOI: 10.1177/15248399231169928
Expanded or Risk Factor-Based Annual Screening for Hepatitis C Virus (HCV)
Among Persons With HIV: Which Is the Best Approach'
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  Authors: Ritche Hao, Ralph Brooks, Alexei Zelenev, Gary Spinner, Lydia Barakat, Merceditas Villanueva
  Abstract: Health Promotion Practice, Ahead of Print.
  Introduction. Universal one-time screening for hepatitis C virus (HCV) is recommended for all adults. For persons with HIV (PWH), guidelines recommend HCV screening at entry into care and annually in men who have unprotected sex with other men (MSM) and persons who inject drugs (PWID). Public health experts recommend expanded annual screening in all PWH given concerns for undiagnosed new HCV diagnoses when risk factors are not assessed. Electronic medical record (EMR) with clinical decision support using a Best Practice Advisory (BPA) tool can aid HCV risk factor assessment. We conducted a prospective study among three HIV clinics to compare the two screening approaches. Methods. Two clinics implemented the EMR-triggered risk factor-based screening; one clinic used the expanded screening approach. We evaluated BPA uptake and compared HCV testing and positivity rates from August 12, 2019 to March 12, 2020. Results. In the risk factor-based screening clinics, of 1,343 PWH, 239 tests were performed with 139 attributed to the BPA (testing rate 10%). At the expanded screening site, among 434 patients, 237 HCV tests were performed (testing rate 55%). The risk factor-based screening sites were less likely to test for HCV (odds ratio [OR] = 0.0884, p < .01) and identify positive cases (OR = 0.55, p = .025). Conclusions. An EMR-based clinical-decision support tool was successfully implemented for HCV risk factor-based screening resulting in a lower HCV annual screening rate compared with an expanded approach. Although in this group of HIV clinics with limited longitudinal follow-up, no previously undiagnosed HCV cases were detected, additional work is needed to guide the design of the best approach.
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T03:00:07Z
  DOI: 10.1177/15248399231169794
Improving HIV and HCV Testing in Substance Use Disorder Programs (SUDs)
That Provide Medications for Opiate Use Disorder (MOUD): Role of
Addressing Barriers and Implementing Universal and Site-Specific
Approaches
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  Authors: Ralph Brooks, Maximilian Wegener, Bob Freeman, Cathy Fowles, Lynn M. Madden, Jeanette M. Tetrault, Lisa Nichols, Frederick L. Altice, Merceditas Villanueva
  Abstract: Health Promotion Practice, Ahead of Print.
  Introduction. National strategies to end the HIV epidemic and eliminate hepatitis c (HCV) through a syndemic approach require improvements in testing for HIV and HCV. Given the intersection of the opioid crisis with HIV and HCV acquisition, substance use disorder (SUD) treatment centers providing medications for opiate use disorder (MOUD) provide a critical opportunity to expand testing. Rates of testing in MOUD clinics have been suboptimal. Method. We employed the Nominal Group Technique (NGT), Ishikawa cause and effect diagrams, and individualized Quality Improvement (QI) efforts at two SUD clinics (SUD A and B) in Connecticut (CT) as part of an HRSA-funded grant focused on improving HCV cure in persons with HIV/HCV coinfection. Baseline and longitudinal data were collected on rates of HIV and HCV testing and positivity as well as linkage to treatment. Results. Between April 1, 2019, and May 31, 2021, for SUD A and B respectively, HIV testing increased from 13% to 90% and 33% to 83%; HCV testing increased from 4% to 90% and 30% to 82%, with few reported cases of HIV/HCV coinfection. HCV testing revealed new and prior diagnoses at both sites, with subsequent referrals for treatment. Qualitative assessments identified best practices which included the institution of formal policies and procedures, streamlining of testing logistics, designation of a site champion, and broadening relevant education to staff and clients. Conclusion. Strategic assessment of barriers and facilitators to HIV and HCV testing at MOUD clinics can lead to improved testing and referral rates that are key to improving the cascade of care for both diseases.
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T02:30:23Z
  DOI: 10.1177/15248399231169791
Characterizing Persons With HIV/HCV Coinfection Who Remain Untreated for
Hepatitis C at Four HIV Clinics in Connecticut (CT): Role of Multiple
Overlapping Barriers at the Individual and Clinic System Levels
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  Authors: Alice Zhao, Maximilian Wegener, Ralph Brooks, Lena Mininberg, Elie Helou, Ashly Maughan, Merceditas Villanueva
  Abstract: Health Promotion Practice, Ahead of Print.
  Introduction. Direct-acting antiviral medications have made hepatitis C virus (HCV) cure possible for>95% of persons with chronic HCV infection, including those coinfected with HIV. Achieving strategic HCV elimination targets requires an understanding of system, provider, and patient-level barriers to treatment. We explored such barriers among persons with HIV/HCV coinfection who remained untreated for HCV. Methods. Among four primary care HIV clinics in CT with high rates of HCV cure, 25 patients with HIV/HCV coinfection were eligible (no HCV treatment as of March 31, 2021). We conducted retrospective chart reviews of demographics, clinical practice patterns, patient-specific issues such as housing, transportation, food security, and presence of mental health and substance use problems. Results. Among untreated patients, 13 (51%) were female; 17 (68%) were Black; median age was 62 years old. The majority (84%) had injecting drug use (IDU) as HIV transmission risk factor; 14 (56%) were prescribed medication-assisted treatment. Median time since HIV and HCV diagnosis was 25 and 19 years, respectively. Clinic-level barriers were noted in 19 (76%) and included lack of evaluation, treatment not recommended or implemented. Concomitant structural barriers included unstable housing for 11 (44%) and lack of transportation for eight (32%). Most patients had history of illicit substance use (84%) and mental health issues (68%). Many (76%) had multiple potential barriers. Conclusions. Multiple overlapping barriers spanning clinic and patient level domains including social determinants of health were the norm in persons with long-standing HIV/HCV coinfection who have not received HCV treatment. Interventions will require innovative, multi-disciplinary and personalized approaches.
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T02:00:02Z
  DOI: 10.1177/15248399231169793
Creating a Longitudinal HCV Care Cascade for Persons With HIV/HCV
Coinfection in Selected HIV Clinics Using Data to Care Methods
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  Authors: Ralph Brooks, Maximilian Wegener, Suzanne Speers, Lisa Nichols, Robert Sideleau, Tequetta Valeriano, Marianne Buchelli, Merceditas Villanueva
  Abstract: Health Promotion Practice, Ahead of Print.
  Highly effective direct-acting antiviral (DAA) treatments for hepatitis C have led to strategic goals promoting hepatitis C virus (HCV) cure particularly in focus populations including persons with HIV/HCV coinfection. Implementing treatment more broadly requires both clinic-level and public health approaches such as those inherent in Data to Care (D2C) originally developed to improve the treatment cascade for persons with HIV (PWH). We used D2C methods to characterize and improve HCV treatment for persons with HIV/HCV coinfection among 11 HIV clinics in Connecticut cities with high PWH prevalence. Providers who were local champions in HCV treatment were recruited to participate along with clinic data staff and were key to quality improvement via practice transformation. We developed a methodology whereby clinic-generated lists of PWH receiving care from 2009 to 2018 were matched by CT Department of Public Health (DPH) against the state-wide HCV surveillance system. The resultant coinfection list was reviewed by clinical staff who designated HCV treatment status, enabling creation of individual clinic-level HCV treatment cascades. Data from DPH, especially current residency and deaths, enabled better characterization and allowed for refinement of longitudinal cascades. There were 1,496 patients with HIV/HCV coinfection. Sustained virologic response (SVR) rates varied by clinic (range, 44%–100%) with an aggregate SVR rate of 71% in September 2020. SVR rates improved during the project through a combination of increased treatment initiation/completion as well as data clean-up including serial updates of patient treatment status. Lack of treatment initiation was associated with being female (odds ratio [OR] = 2.18) and not having HIV viral suppression (OR = 3.24).
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T01:30:10Z
  DOI: 10.1177/15248399231169792
Future Directions for HIV/HCV Care: Lessons Learned From Local Evaluation
Projects in Texas and Connecticut and Implications for Practice and Health
Promotion
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  Authors: Merceditas Villanueva
  Abstract: Health Promotion Practice, Ahead of Print.
  The Health Resources Service Administration (HRSA) Special Projects of National Significance (SPNS) project titled “Curing Hepatitis C among People of Color Living with HIV,” funded two sites, University of Texas (TX) San Antonio and Yale University School of Medicine in Connecticut (CT) to explore barriers and facilitators towards achieving HCV cure in the era of curative DAAs for HCV in different local contexts. Through individualized approaches that study patient, provider and system level barriers, the nine articles in this Focus Issue highlight key themes that are important in designing local implementation strategies that will enable achievement of HCV elimination goals in priority populations.
  Citation: Health Promotion Practice
  PubDate: 2023-07-13T01:00:22Z
  DOI: 10.1177/15248399231169919
The More Things Change, the More They Stay the Same: HIV/AIDS Myths and
Misinformation in the Rural United States
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  Authors: Stacy W. Smallwood, Fayth M. Parks
  Abstract: Health Promotion Practice, Ahead of Print.
  Approaches to HIV/AIDS prevention and treatment have made significant advances since the beginning of the epidemic. However, HIV myths and misinformation continue to persist, stymieing efforts to end the epidemic in the United States, particularly in rural areas. The present study’s purpose was to identify prevalent myths and misinformation about HIV/AIDS in the rural United States. Rural HIV/AIDS health care providers (n = 69) were asked via an audience response system (ARS) to provide responses to questions about HIV/AIDS myths and misinformation in their respective communities. Responses were analyzed qualitatively using thematic coding. Responses were grouped into four thematic categories: risk beliefs, consequences of infection, populations affected, and service delivery. Many responses were consistent with myths and misinformation from the start of the HIV epidemic. Study findings support the need for sustained fundamental HIV/AIDS education and stigma reduction efforts in rural areas.
  Citation: Health Promotion Practice
  PubDate: 2023-07-07T06:03:37Z
  DOI: 10.1177/15248399231180592
Advancing Inclusion of Transgender and Gender-Diverse Identities in
Clinical Education: A Toolkit for Clinical Educators
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  Authors: Whitney Linsenmeyer, Katie Heiden-Rootes, Theresa Drallmeier, Rabia Rahman, Emily Buxbaum, Willow Rosen, Beth Gombos, Ashton Otte
  Abstract: Health Promotion Practice, Ahead of Print.
  Clinical education programs are positioned to train future health care professionals to provide excellent health care for transgender and gender-diverse patients. The purpose of this resource, Advancing Inclusion of Transgender and Gender-Diverse Identities in Clinical Education: A Toolkit for Clinical Educators, is to facilitate critical inquiry among clinical educators regarding their approach to teaching about sex, gender, the historical and sociopolitical context of transgender health, and how to prepare their students to apply standards of care and clinical care guidelines set forth by national and international professional organizations.
  Citation: Health Promotion Practice
  PubDate: 2023-07-05T09:50:57Z
  DOI: 10.1177/15248399231183643
The Pre-Implementation Phase of a Project Seeking to Deliver a
Community-Based CVD Prevention Intervention (SPICES-Sussex): A Qualitative
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  Authors: Thomas Grice-Jackson, Imogen Rogers, Elizabeth Ford, Harm Van Marwijk, Catherine Topham, Geofrey Musinguzi, Hilde Bastiaens, Linda Gibson, Mark Bower, Papreen Nahar
  Abstract: Health Promotion Practice, Ahead of Print.
  Background.Community-led health care interventions may be an effective way to tackle cardiovascular disease (CVD) risk factors, especially in materially deprived communities where health care resources are stretched and engagement with institutions is often low. To do so effectively and equitably, interventions might be developed alongside community members through community engagement.Objectives.The aim of this project was to carry out stakeholder mapping and partnership identification and to understand the views, needs, experiences of community members who would be involved in later stages of a community-based CVD prevention intervention’s development and implementation.Methods.Stakeholder mapping was carried out to identify research participants in three communities in Sussex, United Kingdom. A qualitative descriptive approach was taken during the analysis of focus groups and interviews with 47 participants.Findings.Three themes were highlighted related to intervention design (a) Management: the suitability of the intervention for the community, management of volunteers, and communication; (b) Logistics: the structure and design of the intervention; and (c) Sociocultural issues, the social and cultural expectations/experiences of participants and implementers.Conclusions.Study participants were open and willing to engage in the planned community-based intervention, particularly in elements of co-design and community-led delivery. They also highlighted the importance of sociocultural factors. Based on the findings, we developed recommendations for intervention design which included (but were not limited to): (a) a focus on a bottom-up approach to intervention design, (b) the recruitment of skilled local volunteers, and (c) the importance of fun and simplicity.
  Citation: Health Promotion Practice
  PubDate: 2023-06-30T07:00:31Z
  DOI: 10.1177/15248399231182139
Evaluation of a Mandatory Professional Development on Supporting
Transgender, Nonbinary, and Gender-Nonconforming Students in Chicago
Public Schools
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  Authors: Elizabeth Jarpe-Ratner, A. Bloedel, D. Little, M. DiPaolo, K. Belcher, M. Mangiaracina, B. Marshall
  Abstract: Health Promotion Practice, Ahead of Print.
  To address the reality that LGBTQ+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others) students remain more likely to experience harm, harassment, and violence at school as well as miss school due to feeling unsafe and the fact that students identifying as transgender, nonbinary, and gender-nonconforming (TNBGNC) are at even greater risk of bullying, harassment, and significant mental health concerns, Chicago Public Schools’ (CPS) Office of Student Health and Wellness (OSHW) created a novel professional development (PD) requirement in 2019, entitled “Supporting Transgender, Nonbinary, and Gender Nonconforming Students.” The PD, a recorded webinar encouraging independent time for reflection and planning, takes an intersectional approach and is required of all CPS staff members across the entire district. A pre- and postevaluation of the PD, guided by the Kirkpatrick model, was completed by 19,503 staff members. The findings from this evaluation show that staff members significantly increased their knowledge, showed statistically significant gain in self-reported skills, and articulated key actions they could take toward sustaining an environment that fosters skill implementation and culture change more broadly. Findings reveal that a culture that supports staff members in learning from their mistakes can help to encourage staff members to employ gender-inclusive behaviors such as asking individuals for their pronouns and using gender-neutral pronouns. This districtwide mandatory PD approach shows value in influencing staff members’ thinking and behaviors known to be supportive of TNBGNC students and may serve as a model for other school districts looking to build capacity to support TNBGNC students.
  Citation: Health Promotion Practice
  PubDate: 2023-06-27T01:20:37Z
  DOI: 10.1177/15248399231182161
Mississippi School Food Service Directors’ Interest and Experience With
Local Food Procurement and Farm to School Activities
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  Authors: Jessica L. Thomson, Alicia S. Landry, Tameka I. Walls
  Abstract: Health Promotion Practice, Ahead of Print.
  Background.The purpose of this study was to collect updated school food service purchasing practices from K-12 public school food service directors (SFSD) in Mississippi and to determine their current abilities, experiences, and desires to engage in Farm to School (F2S) activities.Methods.The online survey was created using questionnaire items from existing F2S surveys. The survey opened in October 2021 and closed in January 2022. Descriptive statistics were used to summarize the data.Results.Of the 173 SFSD sent email invitations, 122 (71%) completed the survey. The most common fresh fruit and vegetable purchasing practices included Department of Defense Fresh Program (65%) and produce vendor (64%). Forty-three percent of SFSD purchased at least one locally sourced fruit and 40% purchased at least one locally sourced vegetable, while 46% did not purchase any locally sourced foods. The most common challenges for purchasing from farmers included no relationship with farmers (50%) and food safety regulations (39%). Sixty-four percent of SFSD were interested in at least one F2S activity.Conclusions.Most SFSD do not purchase local foods directly from farmers and almost half do not purchase any local foods regardless of source. Lack of connection with local farmers is a significant challenge to F2S. Recently proposed framework by USDA for shoring up the food supply chain and transforming the food system may help reduce or remove ongoing challenges to F2S participation.
  Citation: Health Promotion Practice
  PubDate: 2023-06-21T10:54:39Z
  DOI: 10.1177/15248399231178543
“Better Than Any DARE Program”: Qualitative Analysis of Adolescent
Reactions to EVALI Television Storylines
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  Authors: Beth L. Hoffman, Jaime E. Sidani, Elizabeth Miller, Jennifer A. Manganello, Kar-Hai Chu, Elizabeth M. Felter, Jessica G. Burke
  Abstract: Health Promotion Practice, Ahead of Print.
  Introduction. Research suggests that awareness of e-cigarette, or vaping, product-use associated lung injury (EVALI) among adolescents is associated with increased harm perception of e-cigarettes. The depiction of EVALI on three primetime medical dramas offers an opportunity to examine the use of these storylines for tobacco prevention education. Methods. We conducted four focus groups with seventh- and eighth-grade students at an urban middle school. Participants viewed three clips of scenes followed by a facilitated discussion as to the influence of the clips on knowledge and perceptions of e-cigarettes and the use of clips for tobacco prevention education. Two research assistants double-coded notes from the focus groups using a qualitative content analysis approach. Results. Our final sample included 78 adolescents; we obtained self-reported demographic information for 75. The majority of participants were 13 to 14 years of age (82.7%) and identified as cisgender female (52.0%) and Black (52.0%). No participants had knowledge of EVALI prior to viewing the clips. Comments made both during and after watching suggest the clips may have reinforced knowledge and perceptions of harm; participants stated that the clips could be a useful intervention tool. Viewing the clips also generated unprompted discussion about flavored products, tobacco advertising, other television programs, and marijuana. Conclusions. Clips featuring the depiction of EVALI on medical dramas may be an effective tool for raising awareness of e-cigarette use-related harms. These results offer a promising first step for future collaborative research between public health, adolescents, and schools to develop tobacco prevention education utilizing these clips.
  Citation: Health Promotion Practice
  PubDate: 2023-06-14T04:01:01Z
  DOI: 10.1177/15248399231177049
Empowering Youth Vaccine Ambassadors to Promote COVID-19 Vaccination in
Local Communities: A 7-Step Approach
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  Authors: Princilla A. Minkah, Amy Borg, Grace W. Ryan, Melissa Goulding, Domenica Perrone, Matilde Castiel, Milagros C. Rosal, Stephenie C. Lemon
  Abstract: Health Promotion Practice, Ahead of Print.
  Despite the availability of COVID-19 vaccines for youth since 2021, vaccine hesitancy has resulted in suboptimal uptake. Public health campaigns that empower local youth ambassadors as trusted messengers who share their personal narratives related to getting vaccinated hold promise for promoting COVID-19 vaccination. We used a seven-step approach to develop, implement, and evaluate a youth-led ambassador campaign to promote COVID-19 vaccine uptake in communities experiencing COVID-19 disparities in Worcester, MA. The seven steps included (1) engaging with key partners; (2) determining a community of focus; (3) identifying trusted sources; (4) determining campaign components; (5) training the vaccine ambassadors; (6) disseminating the campaign; and (7) evaluating the campaign. We trained nine youth as vaccine ambassadors. Ambassadors were guided through self-reflection of motivations for COVID-19 vaccination and the resulting personal narratives became the campaign messaging. English/Spanish vaccine messages developed by youth ambassadors were disseminated through social media platforms (n = 3), radio (n = 2), local TV (n = 2), flyers (n = 2,086), posters (n = 386), billboards (n = 10), and local bus ads (n = 40). Qualitative youth feedback indicate participation in the campaign was a positive and empowering experience which reinforces the importance of engaging youth in public health messaging. Youth empowerment through personal narratives (and storytelling) holds promise for future public health campaigns.
  Citation: Health Promotion Practice
  PubDate: 2023-06-12T06:12:25Z
  DOI: 10.1177/15248399231178542
Mixed-Methods Evaluation of Father Participation in an Adolescent Obesity
Prevention Program With Multiple Delivery Methods
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  Authors: Ghaffar Ali Hurtado Choque, Matthew R. Rodriguez, Darya Soltani, Aysegul Baltaci, Sayaka Nagao-Sato, Silvia Alvarez de Davila, Javiera Monardez, Alejandro Omar Peralta Reyes, Marla Reicks
  Abstract: Health Promotion Practice, Ahead of Print.
  Padres Preparados, Jóvenes Saludables was a Latino family-based obesity prevention intervention implemented from 2017 to 2020 across eight programs in-person only, in a blended format (online/in-person), and online only. The intervention aimed to enhance father parenting skills to improve adolescent diet and activity behaviors. Mothers were encouraged to attend. Factors associated with participation were explored using a mixed-methods, qualitative (focus group/individual interviews by Zoom) and quantitative (process evaluation) design. Eleven focus group and 24 individual interviews were completed after participation with 24 fathers, 27 mothers, and 40 adolescents with responses not sorted by delivery method before analysis. Binomial logistic regression models examined associations between fathers’ program completion and predictor variables of delivery characteristics, father demographic characteristics, and family attendance patterns. Parents were married (96% fathers, 76% mothers), had low income, a high school education or less (68% fathers, 81% mothers), and had lived in the United States a mean of 19 years. Parents were motivated to participate to improve health, and to be involved with and improve communication with their child. Common barriers to participation were work and life priorities and programmatic factors including scheduling conflicts and technological issues. Participation was greater for fathers attending sessions in-person compared with online only (OR = 11.6). Fathers were more likely to participate if they attended sessions with family members vs. not attending with family members (OR = 7.2). To maximize participation, findings suggest involving multiple parents/caregivers and adolescents, addressing contextual and programmatic barriers, and promoting benefits of better health and relations with family members.
  Citation: Health Promotion Practice
  PubDate: 2023-06-10T05:05:41Z
  DOI: 10.1177/15248399231177300
Virtual Health Promotion Work–Integrated Learning Placements: A COVID-19
Consequence or Preparation for the Future'
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  Authors: Teagan Ostrognaj, Claire Bristow, Stavroula Zandes, Dragan Ilic, Bethany Howard
  Abstract: Health Promotion Practice, Ahead of Print.
  We explored student and industry supervisors’ experiences of virtual work-integrated learning (vWIL) health promotion placements during the COVID-19 pandemic. Using a descriptive phenomenological qualitative methodology, we conducted semi-structured interviews with eight students and eight supervisors of undergraduate health promotion–related placements at community, not-for-profit and government organizations. We asked participants about the aspects of their placement they found most enjoyable and challenging, their preparation, workload, and thoughts on placement structure. We audio-recorded and had the interviews transcribed. Our thematic analyses revealed four key themes: (1) the impact of COVID-19 on work and study, (2) benefits of vWIL (real-world application and career clarification, transcending barriers and saving time, and feeling less intimidated), (3) challenges of vWIL (experiencing workplace culture, providing support and guidance to students, and relationship building), and (4) recommendations on the evolution of vWIL (increased preparation and consider a hybrid model). Our findings suggest that vWIL is a viable and sound mode of delivery for health promotion–related placements, particularly in situations that inhibit face-to-face learning. It has the capacity to enhance the work-readiness of health promotion graduates while adding flexibility to professional preparation workplace-based training programs, providing opportunity for capacity building locally across rural and remote areas, as well as globally. Future research should examine the effectiveness, practicality, and feasibility of implementing placements across different models including face-to-face, virtual and hybrid.
  Citation: Health Promotion Practice
  PubDate: 2023-06-09T05:46:13Z
  DOI: 10.1177/15248399231180560
Intervention Fidelity to VITAL Start (Video Intervention to Inspire
Treatment Adherence for Life) in a Randomized Controlled Trial Among Women
Living With HIV in Malawi
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  Authors: Tapiwa A. Tembo, Christine M. Markham, Steven P. Masiano, Rachael Sabelli, Elizabeth Wetzel, Saeed Ahmed, Mtisunge Mphande, Angella M. Mkandawire, Mike J. Chitani, Innocent Khama, Rose Nyirenda, Alick Mazenga, Elaine J. Abrams, Maria H. Kim
  Abstract: Health Promotion Practice, Ahead of Print.
  Background:Intervention effectiveness in a randomized controlled trial is attributed to intervention fidelity. Measuring fidelity has increasing significance to intervention research and validity. The purpose of this article is to describe a systematic assessment of intervention fidelity for VITAL Start (Video intervention to Inspire Treatment Adherence for Life)—a 27-minute video-based intervention designed to improve antiretroviral therapy adherence among pregnant and breastfeeding women.Method:Research Assistants (RAs) delivered VITAL Start to participants after enrolment. The VITAL Start intervention had three components: a pre-video orientation, video viewing, and post-video counseling. Fidelity assessments using checklists comprised self (RA assessment) and observer (Research Officers, also known as ROs) assessment. Four fidelity domains (adherence, dose, quality of delivery, and participant responsiveness) were evaluated. Score scale ranges were 0 to 29 adherence, 0 to 3 dose, 0 to 48 quality of delivery and 0 to 8 participant responsiveness. Fidelity scores were calculated. Descriptive statistics summarizing the scores were performed.Results:In total, eight RAs delivered 379 VITAL Start sessions to 379 participants. Four ROs observed and assessed 43 (11%) intervention sessions. The mean scores were 28 (SD = 1.3) for adherence, 3 (SD = 0) for dose, 40 (SD = 8.6) for quality of delivery, and 10.4 (SD = 1.3) for participant responsiveness.Conclusion:Overall, the RAs successfully delivered the VITAL Start intervention with high fidelity. Intervention fidelity monitoring should be an important element of randomized control trial design of specific interventions to ensure having reliable study results.
  Citation: Health Promotion Practice
  PubDate: 2023-06-07T05:45:44Z
  DOI: 10.1177/15248399231177303
Remote Evidence-Based Health Promotion Programs During COVID: A National
Evaluation of Reach and Implementation for Older Adult Health Equity
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  Authors: Lesley Steinman, Erica Chavez Santos, Kelly Chadwick, Caitlin Mayotte, Selisha (Snowy) Johnson, Marlana Kohn, James Kelley, Paige Denison, Clarissa Montes, Lesha Spencer-Brown, Kate Lorig
  Abstract: Health Promotion Practice, Ahead of Print.
  Introduction.Evidence-based health promotion programs (EBPs) support older adults where they live, work, pray, play, and age. COVID-19 placed a disproportionate burden on this population, especially those with chronic conditions. In-person EBPs shifted to remote delivery via video-conferencing, phone, and mail during the pandemic, creating opportunities and challenges for older adult health equity.Method.In 2021–2022, we conducted a process evaluation of remote EBPs by purposively sampling diverse U.S. organizations and older adults (people of color, rural, and/or with disabilities). The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) + Equity framework was used to understand program reach and implementation, including FRAME to describe adaptations for remote delivery. Analyses include descriptive statistics and thematic analysis of participant and provider surveys and interviews, and joint display tables to compare learnings.Results.Findings from 31 EBPs through 198 managers/leaders and 107 organizations suggest remote delivery increases EBP reach by improving access for older adults who are underserved. For programs requiring new software or hardware, challenges remain reaching those with limited access to—or comfort using—technology. Adaptations were to context (e.g., shorter, smaller classes with longer duration) and for equity (e.g., phone formats, autogenerated captioning); content was unchanged except where safety was concerned. Implementation is facilitated by remote delivery guidelines, distance training, and technology support; and hindered by additional time, staffing, and resources for engagement and delivery.Conclusions.Remote EBP delivery is promising for improving equitable access to quality health promotion. Future policies and practices must support technology access and usability for all older adults.
  Citation: Health Promotion Practice
  PubDate: 2023-06-07T05:42:25Z
  DOI: 10.1177/15248399231175843
Using Plan, Do, Study, Act Cycles to Improve a Maternal Self-Care
Intervention With Audience Input
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  Authors: Savannah Hobbs, Laura L. Bellows, J. Douglas Coatsworth, Susan L. Johnson
  Abstract: Health Promotion Practice, Ahead of Print.
  Maternal self-care, including healthy eating, physical activity, and stress management behaviors, is influenced by environmental, social, and individual factors. Plan-Do-Study-Act (PDSA) Cycling is an effective quality improvement process using rapid cycling to refine interventions to fit audience-specific contexts and to address socioecological influences on behavior change. To refine components of the Healthy EnviROnmentS Self-Care intervention, a mindful self-care program for mothers of preschool-aged children in rural communities, PDSA cycles were used to examine: (A) acceptability of content, (B) suitability of implementation strategies, and (C) feasibility of digital supports across three stages of program development. Stage 1 included a group discussion with an expert panel (n = 8). Stage 2 used brief interviews and group discussion with a convenience sample (n = 5). Stage 3 included in-depth interviews with the focal population (n = 6). In-depth interviews were transcribed and analyzed using a directed approach, and data were compiled from group discussion notes and assessed for congruence and analyzed for emergent themes. PDSA cycles relating to content led to the addition of activities to introduce mindfulness and foster social support and the revision of handouts. Implementation strategies were refined with respect to workshop duration, activity order, and meeting type. Digital supports resulted in refinement to the study website and tablet applications. Utilization of PDSA cycles allowed for input from the focus population at every point of intervention design and considered socioecological factors that can influence behavior change.
  Citation: Health Promotion Practice
  PubDate: 2023-06-05T06:12:28Z
  DOI: 10.1177/15248399231177305
Cultural Predictors of Self-Esteem Among Black Women With Criminal Justice
Involvement and Herpes Simplex Virus
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  Authors: Natalie Malone, Jardin N. Dogan-Dixon, Shemeka Thorpe, Shawndaya S. Thrasher, Paris Wheeler, Danelle Stevens-Watkins, Carrie B. Oser
  Abstract: Health Promotion Practice, Ahead of Print.
  Black women have disproportionately alarming HSV-2 infection rates yet receive little attention in sexual health literature. Using a strengths-based resilience framework, this study sought to determine culturally relevant protective predictors of self-esteem for Black women who are justice-involved and have HSV-2. The authors conducted secondary data analysis on data from the “Black Women in the Study of Epidemics (B-WISE) Project,” a longitudinal prospective study investigating health disparities and health services utilization among Black women with justice involvement. At baseline, N = 151 Black women with HSV-2 who were incarcerated or on probation completed survey measures assessing self-esteem, ethnic identity affirmation and belonging, perceived social support, and John Henryism Active Coping. Hierarchical linear regression analyses revealed ethnic identity affirmation and belonging and John Henryism Active Coping were significant predictors of self-esteem at 6-month follow-up. Implications are provided for current health professionals.
  Citation: Health Promotion Practice
  PubDate: 2023-06-02T10:07:58Z
  DOI: 10.1177/15248399231171951
Achieving Our Moemoeā: Community-Led Food Security Strategy
Development
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  Authors: Manawatū Food Action Network, Christina Severinsen, Angelique Reweti
  Abstract: Health Promotion Practice, Ahead of Print.
  The Manawatū Food Action Network (MFAN) is a collective of social service and environmental organizations and community stakeholders that work together to promote collaboration, education and awareness of issues surrounding food security, food resilience, and localization in the local community. In 2021, the 4412 neighborhood was identified as requiring urgent assistance, with approximately one third of residents experiencing food insecurity. The 4412 Kai Resilience Strategy was developed with the community to move from food insecurity to food resilience and sovereignty. Recognizing that food security is complex and based on multiple causes, six interwoven workstreams were identified to create a multifaceted, coordinated strategy. This includes education, food economy, community, food support, māra kai, and social enterprise. The strategy cultivates local ownership and commitment to change. It creates a broader constituency of support, balancing the urgent need to feed people today with the long-term need to change systems through step-change initiatives. Through this approach, communities can better make sustainable and meaningful changes to their lives and circumstances rather than relying on external resources.
  Citation: Health Promotion Practice
  PubDate: 2023-05-26T08:16:44Z
  DOI: 10.1177/15248399231177051
A WIC-Based Behavior Change Intervention for Postpartum Women With
Overweight and Obesity: A Pilot Feasibility Randomized Trial
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  Authors: Darcy A. Thompson, Matthew A. Haemer, Nancy F. Krebs, Rocio I. Pereira, Angela Moss, Anna L. Furniss, Jill Bonczynski, Jacinda M. Nicklas
  Abstract: Health Promotion Practice, Ahead of Print.
  Background. Postpartum weight retention is a risk factor for obesity and is particularly important among Hispanic women who have an increased rate of obesity. Given its broad reach, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program provides an ideal setting to implement community-based interventions for low-income postpartum women. Purpose. To examine the feasibility, acceptability, and preliminary efficacy of a multicomponent intervention delivered by staff within the WIC program designed to promote behavior changes in urban, postpartum women with overweight/obesity. Method. This was a 12-week pilot trial randomizing participants to a health behavior change (Intervention) or control (Observation) group. The Intervention included monthly visits with trained WIC staff providing patient-centered behavior change counseling, with multiple touchpoints between visits promoting self-monitoring and offering health behavior change support. Results. Participants (n = 41), who were mainly Hispanic (n = 37, 90%) and Spanish-speaking (n = 33, 81%), were randomized to the Intervention (n = 19) or Observation (n = 22) group. In the Intervention group, 79% (n = 15) of eligible participants were retained for the study duration. All Intervention participants endorsed that they would participate again. Regarding physical activity, participant readiness to change and self-efficacy improved for Intervention participants. About one-quarter of women in the Intervention group (27%, n = 4) had a 5% weight loss compared with one woman (5%) in the Observation group; this difference was not statistically significant (p = .10). Conclusions. This pilot demonstrated the feasibility and acceptability of delivering a low-intensity behavior change intervention within the WIC setting for postpartum women with overweight/obesity. Findings support the role of WIC in addressing postpartum obesity.
  Citation: Health Promotion Practice
  PubDate: 2023-05-25T09:41:50Z
  DOI: 10.1177/15248399231173704
The Moby Bookmobile: Providing Health Education Materials in Wyoming
Indian Country
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  Authors: Robin Levin, David Brown, John Bramble
  Abstract: Health Promotion Practice, Ahead of Print.
  The COVID-19 pandemic made it difficult for Native American populations to access health information. Through funding from the Network of The National Library of Medicine Region 4, a community library was able to enhance their native and nonnative health collections for distribution on the Wind River Reservation in Central Wyoming. The book mobile was originally funded by the Wyoming State Library through American Rescue Plan Act of 2021 funding to increase literacy efforts during the pandemic. Materials were distributed at multiple locations throughout the reservation and individuals indicated they appreciated the materials being provided. This program was successful in distributing health information to an underserved priority population within the United States. Hopefully, similar programs would be successful in enhancing health education programs with other priority populations in both the United States and the world.
  Citation: Health Promotion Practice
  PubDate: 2023-05-24T11:15:03Z
  DOI: 10.1177/15248399231176252
A Unique Model and Workforce to Address Health-Related Social Needs and
Health Equity: Regional Health Connectors in Colorado
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  Authors: Jennifer K. Carroll, Douglas H. Fernald, Tristen L. Hall, Hannah M. Groves, Gillian Grant, Ashley Sherrill, Kristin Crispe, Ashlie Brown, Sarah Lampe, W. Perry Dickinson
  Abstract: Health Promotion Practice, Ahead of Print.
  Unmet health-related social needs contribute to high morbidity and poor population health. Improving social conditions are likely to reduce health disparities and improve the health of the overall U.S. population. The primary objective of this article is to describe an innovative workforce model, called Regional Health Connectors (RHCs), and how they address health-related social needs in Colorado. This is a program evaluation that analyzed field notes and interview data from 2021-2022. We applied our findings to the framework developed by the National Academies of Sciences, Engineering, and Medicine’s (NASEM’s) report on strengthening social care integration into health care (2019). We found that RHCs address the following health-related social needs most commonly: food insecurity (n = 18 of 21 regions or 85% of all regions), housing (n = 17 or 81% of all regions), transportation (n = 11 or 52% of all regions), employment opportunities (n = 10 or 48% of all regions), and income/financial assistance (n = 11 or 52% of all regions). RHCs interacted across many sectors to address health-related social needs and provided multiple types of support to primary care practices at the organizational level. Examples of emerging impact of RHCs are described and mapped onto the NASEM framework. Findings from this program evaluation add to the growing landscape of knowledge and importance of detecting and addressing health-related social needs. We conclude that RHCs are a unique and emerging workforce that addresses multiple domains needed to integrate social care into health care.
  Citation: Health Promotion Practice
  PubDate: 2023-05-24T11:08:44Z
  DOI: 10.1177/15248399231173703
Developing a Youth Participatory Action Research Program for Latine Youth
in an Emerging Community
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  Authors: Christina Huerta, Benjamin Gutschow, Josefina Bañales, Hillary Boyzo, Veronica Jenkins, Patricia Document, Sharon E. Taverno, Sara Goodkind, Maya I. Ragavan
  Abstract: Health Promotion Practice, Ahead of Print.
  In this practice note, we document the development of a youth participatory action research (YPAR) program designed by and for Latine youth residing in a small but rapidly growing Latine community. Our community–academic team partnered to cocreate a YPAR curriculum focused on supporting Latine youth in learning about research and developing their own research projects. Participants in the pilot year worked on Photovoice projects centered on topics they identified, including preventing colorism and machismo and increasing access to mental health services. We reviewed lessons learned from this work, including challenges engaging young people and creating linguistically inclusive spaces.
  Citation: Health Promotion Practice
  PubDate: 2023-05-22T09:41:25Z
  DOI: 10.1177/15248399231176248
Multi-Level Influences of Smoke-Free Policies in Subsidized Housing:
Applying the COM-B Model and Neighborhood Assessments to Inform Smoke-Free
Policies
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  Authors: Maya Vijayaraghavan, Marlena Hartman-Filson, Priyanka Vyas, Toshali Katyal, Tram Nguyen, Margaret A. Handley
  Abstract: Health Promotion Practice, Ahead of Print.
  Smoke-free policies in multi-unit housing are associated with reduced exposure to secondhand smoke (SHS); however, attitudes toward comprehensive smoke-free policies among residents in subsidized multi-unit housing are unknown. In this mixed-methods study, we explored the socio-ecological context for tobacco and cannabis use and attitudes toward policies restricting indoor use of these products through interviews with residents (N = 134) and staff (N = 22) in 15 federally subsidized multi-unit housing in San Francisco, California. We conducted a geo-spatial and ethnographic environmental assessment by mapping alcohol, cannabis, and tobacco retail density using ArcGIS, and conducted systematic social observations of the neighborhood around each site for environmental cues to tobacco use. We used the Capability, Opportunity, and Motivation behavior (COM-B) model to identify factors that might influence implementation of smoke-free policies in multi-unit housing. Knowledge and attitudes toward tobacco and cannabis use, social norms around smoking, neighborhood violence, and cannabis legalization were some of the social-ecological factors that influenced tobacco use. There was spatial variation in the availability of alcohol, cannabis, and tobacco stores around sites, which may have influenced residents’ ability to maintain smoke-free homes. Lack of skill on how to moderate indoor smoking (psychological capability), lack of safe neighborhoods (physical opportunity), and the stigma of smoking outdoors in multi-unit housing (motivation) were some of the barriers to adopting a smoke-free home. Interventions to increase adoption of smoke-free policies in multi-unit housing need to address the co-use of tobacco and cannabis and commercial and environmental determinants of tobacco use to facilitate smoke-free living.
  Citation: Health Promotion Practice
  PubDate: 2023-05-20T12:50:03Z
  DOI: 10.1177/15248399231174925
Designing and Evaluating Opioid Misuse Prevention Training for Rural
Communities and Health Care Providers
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  Authors: Cheryl L. Eschbach, Bengt B. Arnetz, Judith E. Arnetz
  Abstract: Health Promotion Practice, Ahead of Print.
  Through Substance Abuse and Mental Health Services Administration funding, Michigan State University (MSU) Extension partnered with MSU’s Family Medicine and Health Department of Northwest Michigan to implement trainings for community members and health care providers to increase awareness and improve prevention efforts addressing opioid use disorder (OUD) in rural areas. We formed the Michigan Substance Use Prevention, Education and Recovery (MiSUPER) project to design and evaluate opioid misuse prevention trainings. A socio-ecological prevention model was an underlying conceptual framework for this project and drove strategies used in trainings, products created, and measurement. The purpose of this study is to determine the effectiveness of one-time online educational training events for rural community members and health care providers on community OUD issues, treatment options, and supports for those in recovery. Between 2020 and 2022, rural participants completed pre- and posttraining, and 30-day follow-up evaluation surveys. We report the demographic characteristics of community (n = 451) and provider (n = 59) participants, self-reported knowledge gained, and overall perceptions of the trainings. Findings show community members’ knowledge increased from pre- to posttraining (p < .001) and was maintained at 3 months, while providers’ knowledge was unchanged over time. Posttraining, community participants felt more comfortable speaking about addiction with family and friends (p < .001), and providers had better knowledge of local resources for patients who could not afford opioid misuse treatments (p < .05). All participants reported gaining knowledge of community resources for opioid misuse prevention, treatment, and recovery (p < .01). Opioid misuse prevention trainings may be most effective when adapted to leverage local resources.
  Citation: Health Promotion Practice
  PubDate: 2023-05-18T09:54:33Z
  DOI: 10.1177/15248399231174920
Using Grand Rounds to Train and Prepare a Local Public Health Workforce To
Manage COVID-19 Outbreaks During the 2020–2021 Pandemic Winter Upsurge
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  Authors: Lori Fischbach, Lisa V. Smith, Jan King, Moira Inkelas, Tony Kuo
  Abstract: Health Promotion Practice, Ahead of Print.
  In response to the coronavirus disease 2019 (COVID-19) pandemic, the Los Angeles County Department of Public Health (DPH) expanded its workforce by>250 staff during Fall 2020 to manage the expected volume of outbreaks, which ultimately peaked. The workforce included reorganized groups of physicians, nurses, outbreak investigators from several DPH programs, and a 100+ member data science team tasked with designing and operating a data system and information flow process that became the backbone infrastructure of support for field investigation and outbreak management in real-time. The accelerated workforce expansion was completed in 3 months. To prepare new and reassigned permanent staff for fieldwork, DPH and several faculty from the Emory University Rollins School of Public Health adopted a flexible, skills-based series of medical Grand Rounds. These 16 sessions were grounded in practice- and problem-based learning principles using case studies, interactive scenarios, and didactic presentations based on scientific and public health practice information to teach knowledge and skills that were needed to manage COVID-19 outbreaks in different sectors. The evaluation suggests positive experience with the training series as well as impact on job performance.
  Citation: Health Promotion Practice
  PubDate: 2023-05-17T11:29:38Z
  DOI: 10.1177/15248399231171952
Using Community-Based Participatory Research to Conduct a Collaborative
Needs Assessment of Mental Health Service Users: Identifying Research
Questions and Building Academic-Community Trust
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  Authors: Jonathan Delman, Diana Arntz, Anne Whitman, Hannah Skiest, Katherine Kritikos, Paul Alves, Valeria Chambers, Ryan Markley, Jacqueline Martinez, Cynthia Piltch, Sandra Whitney-Sarles, Julia London, Derri Shtasel, Corinne Cather
  Abstract: Health Promotion Practice, Ahead of Print.
  Attempts to meaningfully engage people with serious mental illnesses (SMI) as allies in conducting research have often failed because researchers tend to decide on the research topic without including community members. Academic researchers can avoid this pitfall by collaborating with community members to conduct a needs assessment to identify relevant research topics and build trust. Here, we report on the results of a psychosocial needs assessment for adult mental health service users in Massachusetts conducted by an academic-peer research team. The project was initiated as part of an academic mental health center’s efforts to conduct community-based participatory research (CBPR) with a group of people with SMI. People with SMI were hired and trained to co-lead research projects and the development of the listening group guide, and they conducted 18 listening groups with 159 adults with mental health conditions. The data were transcribed, and rapid analysis employing qualitative and matrix classification methods was used to identify service need themes. Six themes emerged from qualitative analysis: reduce community and provider stigma, improve access to services, focus on the whole person, include peers in recovery care, have respectful and understanding clinicians, and recruit diverse staff. The policy and practice implications of these findings include creating a stronger culture of innovation within provider organizations, developing specific plans for improving recruitment and retention of peer workers and a multicultural workforce, enhancing training and supervision in cultural humility, communicating respectfully with clients, and including peers in quality improvement activities.
  Citation: Health Promotion Practice
  PubDate: 2023-05-13T07:14:47Z
  DOI: 10.1177/15248399231171144
Equity Lens Protocol: Reflecting on Harms From the COVID-19 Response and
Mitigation Strategies Implemented in a Local Public Health System
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  Authors: Stephen Fawcett, Christina Holt, Orielle Solar-Hormazabal, Gerry Eijkemans, Dan Partridge, Sonia Jordan, Charlie Bryan, Aihua Zhu, Alex Kimball Williams, Ruaa Hassaballa-Muhammad, Erica Hill
  Abstract: Health Promotion Practice, Ahead of Print.
  This report describes an Equity Lens Protocol and its use to guide partners’ systematic reflection on harms and mitigation strategies of the COVID-19 response in a local public health system. This process evaluation tool is based on the Guidance document for assuring an equitable response to COVID-19 prepared by the Pan American Health Organization. We used a participatory approach to engage public health partners in systematically reflecting on harms, mitigation strategies, and lessons learned and implications for practice. Outputs from using this tool included identified: (a) specific harms (e.g., loss of income and challenges to learning) related to particular COVID-19 response measures (e.g., home confinement and school closure) and (b) mitigation strategies implemented to reduce harms. In response to the protocol’s guiding questions, partners also identified lessons learned and practice recommendations for strengthening equity work in public health responses (e.g., an equitable response requires an investment in people, structures, and relationships before a crisis). This report—and accompanying protocol—illustrates use of a practical method for systematic reflection on public health responses through an equity lens.
  Citation: Health Promotion Practice
  PubDate: 2023-05-13T07:04:08Z
  DOI: 10.1177/15248399231173702
Local Implementation of Move Your Way—A Federal Communications Campaign
to Promote the Physical Activity Guidelines for Americans
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  Authors: Kate Olscamp, Malorie Polster, Elizabeth Y. Barnett, Mikaela A. Momot, Rachel N. Oziel, Frances Bevington
  Abstract: Health Promotion Practice, Ahead of Print.
  Background. The U.S. Department of Health and Human Services (HHS) developed the Move Your Way campaign to help more Americans increase their physical activity. The campaign includes more than 80 English and Spanish materials that can be used to promote physical activity. HHS also developed a community-based implementation strategy for the campaign. Methods. HHS collaborated with eight community-based organizations from across the United States to pilot campaign implementation in their communities. A mixed-methods process evaluation was conducted to assess events, partnership involvement, material distribution, and social media engagement. Results. More than 168,000 people participated in 55 campaign events, initiatives, and programs hosted by lead organizations and their 175 partners. More than 37,000 campaign materials were distributed, and there were over 72 million social media impressions. Conclusion. The community-based implementation strategy was effective at reaching the intended audience and driving traffic to Move Your Way resources. The flexibility of the Move Your Way materials and messages allowed communities to incorporate the campaign into diverse physical activity–promotion strategies. Findings demonstrate that the federal government and local community organizations can successfully work together to promote physical activity.
  Citation: Health Promotion Practice
  PubDate: 2023-05-12T11:30:55Z
  DOI: 10.1177/15248399231172468
An Implementation of a Community-Engaged, Group-Level Mental Health Pilot
for Black and Latina Transgender Women
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  Authors: Hale M. Thompson, Ketzel Feasley, Reyna Ortiz, Karen Reyes, Amanda Seanior, Niranjan S. Karnik
  Abstract: Health Promotion Practice, Ahead of Print.
  The primary aim is to assess the implementation of an eight-session, group therapy pilot for Black and Latina transgender women in Chicago in terms of implementation outcomes regarding intervention effectiveness, acceptability, appropriateness, and feasibility. The Exploration Preparation Implementation Sustainment (EPIS) framework guided implementation processes, including community engagement as an implementation strategy, and an implementation taxonomy was used to evaluate outcomes of acceptability, appropriateness, and feasibility, in addition to intervention effectiveness regarding anxiety and community connectedness. Two rounds of the pilot were completed in 2020, during the COVID-19 pandemic, at a community-based organization serving LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning) youth on Chicago’s West Side. Participants (N = 14) completed a baseline and postintervention assessment and evaluations after each of eight intervention modules. Descriptive statistics show improvement across measures of anxiety and community connectedness, and high mean scores across domains of acceptability, appropriateness, and feasibility. Pilot findings indicate intervention effectiveness, acceptability, appropriateness, and feasibility to address mental health and social support of Black and Latina transgender women. Additional resources are needed for transgender community-engaged mental health programs and research to establish core and adaptable intervention elements, scaled-up evidence for clinical effectiveness, and, most importantly, to improve mental health outcomes and the sustainability of such interventions.
  Citation: Health Promotion Practice
  PubDate: 2023-05-12T11:27:49Z
  DOI: 10.1177/15248399231172191
Factors That Help and Hinder the Implementation of Community-Wide Behavior
Change Programs
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  Authors: Marc Harris, Diane Crone, Samantha Hughes
  Abstract: Health Promotion Practice, Ahead of Print.
  Novel community-wide approaches that gamify physical activity through challenges and competition have become increasingly popular in recent years. However, little is known about the factors that help or hinder their implementation. This qualitative study aimed to address this gap in the literature by systematically investigating the facilitators (organizational and experiential) and barriers to successful implementation of a community-wide intervention delivered in Gloucester, the United Kingdom. A two-phased process evaluation was conducted. Phase 1 involved the thematical analysis of open question feedback from n = 289 adults. Phase 2 included three focus groups conducted with n = 12 participants. This research showed that promoting the initiative through primary education settings was fundamental to enhancing awareness and participation. Social elements of the intervention were identified as a motivating factor for, and a consequential outcome of, participation. A lack of promotion to wider-reaching proportions of the community was perceived to be a significant barrier to implementation, potentially limiting inclusivity and participation in the activity. Game dynamics, timing, and fears regarding sustainability represented further difficulties to implementation.
  Citation: Health Promotion Practice
  PubDate: 2023-05-11T09:18:37Z
  DOI: 10.1177/15248399231172760
Cultivating a Sense of Belonging in Allied Health Education: An Approach
Based on Mindfulness Anti-Oppression Pedagogy
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  Authors: Francoise A. Knox-Kazimierczuk, Brandelyn Tosolt, Kevin V. Lotz
  Abstract: Health Promotion Practice, Ahead of Print.
  To address accreditation standards and to meet a need due to a disparity in health care providers engaged in direct patient care, many institutions of higher education have focused on initiatives to increase the numbers of ethnic and racial minority populations. Despite these efforts, there remains a dearth of diversity in health care. For many underrepresented minority populations (URM), numerous barriers exist to becoming a health professional. Greater levels of discrimination and bias reduce belonging and agency in URM students impacting recruitment and retention. Research has shown that discrimination and bias are antithetical to feeling a sense of belonging on college campuses for URM students. The sense of belonging for URM students has been positively linked to retention and other academic outcomes. Faculty interaction and campus environment have been correlated to sense of belonging. Thus, faculty members as mentors, advisors, and shapers of campus climate have an important role to play in supporting URM students. However, due to socialization in an oppressive society, narratives about race and racism can become entrenched. The entrenchment of racial ideologies, without tools to examine, deconstruct, and reflect, leads to little forward progress. Incorporation of mindfulness anti-oppression pedagogy provides a needed paradigm shift for allied health educators to act with intentionality as they cultivate spaces of belonging for URM students.
  Citation: Health Promotion Practice
  PubDate: 2023-05-09T07:08:38Z
  DOI: 10.1177/15248399231172761
Firearm Safe Storage in Rural Families: Community Perspectives About
Ownership and Safety Messaging
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  Authors: Cynthia Ewell Foster, Sarah Derwin, Lindsay A. Bornheimer, Christina Magness, Eskira Kahsay, Meredith Eis, Juliann Li Verdugo, Tayla Smith, Lynn Massey, Frederick P. Rivara, Cheryl A. King
  Abstract: Health Promotion Practice, Ahead of Print.
  Firearm-related injuries are the leading cause of death among youth in the United States, and rates of firearm-related suicide in rural youth are more than double those in urban youth. Although safe firearm storage has been shown to reduce firearm injuries, little is known about how to culturally tailor such interventions for rural families in the United States. Informed by community-based participatory methods, focus groups and key informant interviews were conducted to design a safe storage prevention strategy for rural families. Participants included a broad array of community stakeholders (n = 40; 60% male, 40% female; age 15–72, M = 36.9, SD = 18.9) who were asked to identify acceptable messengers, message content, and delivery mechanisms that were perceived as respectful to the strengths of rural culture. Independent coders analyzed qualitative data using an open coding technique. Emerging themes included (1) community norms, values, and beliefs about firearms; (2) reasons for ownership; (3) firearm safety; (4) storage practices; (5) barriers to safe storage; and (6) suggested intervention components. Firearms were described as a “way of life” and family tradition in rural areas. Owning firearms for hunting and protection influenced family storage decisions. Intervention strategies that use respected firearm experts as messengers, refer to locally derived data, and that reflect community pride in firearm safety and responsible ownership may improve the acceptability of prevention messages in rural areas.
  Citation: Health Promotion Practice
  PubDate: 2023-05-06T10:14:01Z
  DOI: 10.1177/15248399231166418
Implementation of Quitline Financial Incentives to Increase Counseling
Sessions Among Adults Who Use Menthol Tobacco Products
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  Authors: Dana E. Bourne, Rhonda Williams, Lisa Osbahr, Maria Roemhildt, Andrea C. Villanti
  Abstract: Health Promotion Practice, Ahead of Print.
  Since 2017, the Vermont Tobacco Control Program (VTCP) has worked to reduce the impact of flavored tobacco products on Vermonters. With the proposed U.S. Food and Drug Administration (FDA) rules banning menthol cigarettes and flavored cigars and proposed legislation banning sales of all menthol and flavored tobacco products in Vermont, VTCP prioritized resources to support cessation among Vermonters who use menthol tobacco products. In March 2021, VTCP began offering a tailored quitline protocol for adults who use menthol tobacco, including financial incentives, for completed coaching sessions. From March 2021 to May 2022, 66 quitline callers enrolled in the menthol incentive protocol, representing 8% of all quitline callers and 25% of participants in the state’s quitline incentive programs. A greater proportion of callers in the menthol incentive program completed three or more quitline calls (58% vs. 38%) and enrolled in phone and text support (61% vs. 32%). Quitline callers enrolled in any incentive protocols (menthol, Medicaid/uninsured, or pregnant) were more likely to request one or two forms of nicotine replacement therapy (NRT). Quitlines remain an effective, evidence-based method of tobacco cessation, especially in reaching vulnerable populations. Given the targeted marketing of menthol brands to Black and African American populations, LGBTQ+ populations, youth, and neighborhoods with lower incomes, addressing menthol cigarette use is key to improving health equity and health of Vermonters. Early data indicates that the use of financial incentives can increase engagement with a state quitline among menthol tobacco users through greater completion of cessation coaching calls, enrollment in text message support, and NRT usage.
  Citation: Health Promotion Practice
  PubDate: 2023-04-29T06:35:01Z
  DOI: 10.1177/15248399231171143
Healing Baltimore: Creating Support for VALUE (Vaccine Access &
Acceptance, Lives in Unity, Education & Engagement) Baltimore Ambassadors
as They Serve During the COVID-19 Pandemic
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  Authors: Mackessa Holt, Evelyn Ruiz-Aguilera, Gloria Ngeno, Yvonne Bronner
  Abstract: Health Promotion Practice, Ahead of Print.
  VALUE (Vaccine Acceptance & Access Lives in Unity, Engagement & Education) Baltimore began in February 2021 with the vision of helping underserved communities in Baltimore City value COVID-19 vaccination and have access to the vaccine. VALUE dispatched ambassadors to provide COVID-19 education and risk-mitigation strategies in their communities. Once the project was implemented, we noticed that our ambassadors were often overwhelmed by misinformation in the community and our priority populations faced deeper issues relating to the social determinants of health (SDOH) and social needs such as food, transportation, job loss, and housing.To help our ambassadors cope with and address these issues, we created Healing Baltimore in April 2021. Healing Baltimore aims to support our VALUE ambassadors as they contribute toward improving the wellbeing of Baltimore now and after COVID. Healing Baltimore has four elements: (1) Weekly Self-Care Tips, (2) Weekly Positive Facts about Baltimore, (3) SDOH Referral to Baltimore City Health Department Services, and (4) Webinars to teach us about the VALUE communities while offering the opportunity to discuss historical trauma. We share our lessons learned from Healing Baltimore, which include (1) increasing ambassador input, (2) engagement, (3) co-creation, (4) collaboration, and (5) community appreciation.
  Citation: Health Promotion Practice
  PubDate: 2023-04-19T06:53:16Z
  DOI: 10.1177/15248399231166714
“Did You Wash Your Hands'” The Socioeconomic Inequalities Preventing
Youth From Adopting Protective Behaviors During COVID-19 in South Africa
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  Authors: Nicole De Wet-Billings
  Abstract: Health Promotion Practice, Ahead of Print.
  Background. Behavior change has been a critical factor in slowing the spread of COVID-19. In South Africa where infection rates are high, research is needed on the protective behaviors adopted by youth who have low infection rates but are carriers of the virus. Aims. The purpose of this study is to (1) identify the protective behaviors young people adopted during the pandemic and (2) to estimate the probability of positive behavior change by demographic and socioeconomic characteristics. Methods. The study uses data from the South African National Income Dynamics—Coronavirus Rapid Mobile Survey 2020. The sample includes 985 (n) youth aged 15–24 years. The outcome of interest is behavior change due to the Coronavirus. Cross-tabulations and an adjusted binary logistic regression model showing odds ratios, are fit to the data. Results. Not all youth adopted protective behaviors. The most prevalent behaviors adopted include washing hands (67.75%) and staying at home (54.02%). Youth in households with six or more members are more likely to change their behaviors (ORs = 1.67 and 1.64, both p-values < .05). However, youth who do not have access to water to wash hands (OR = 0.71), reside in households with food insecurity (OR = 0.94), and those living in nonformal housing (OR = 0.69) are less likely to adopt behavior change. Conclusion. Due to the socioeconomic inequalities associated with behavior change, there is need for more tailored approaches to address youth living in impoverished households in the country.
  Citation: Health Promotion Practice
  PubDate: 2023-04-15T11:19:37Z
  DOI: 10.1177/15248399231166713
Elevating Women’s Voices: The Illinois Maternal Health Digital
Storytelling Project
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  Authors: Abigail Holicky, Anne Elizabeth Glassgow, Allison Myers, April J. Bell
  Abstract: Health Promotion Practice, Ahead of Print.
  Numerous initiatives at the national, state, and local levels are focused on addressing the U.S. maternal health crisis. However, most efforts fail to center women’s voices and personal perspectives about pregnancy experiences and complications. This article describes the Illinois Maternal Health Digital Storytelling Project conducted by the University of Illinois at Chicago, in partnership with StoryCenter, a storytelling nonprofit organization based in Berkeley, California. The project aimed to elevate voices (stories) to complement other sources of data on maternal outcomes. We relied on partners to help recruit storytellers with a self-identified perinatal-related challenge. We screened interested individuals using a trauma-informed approach and a social worker provided storytellers with support during the project. Two groups participated in this project, one in 2021 and another in 2022, culminating with 10 digital stories. Both instances were conducted virtually and included group and individual skills-based sessions where storytellers learned to create and edit their digital stories. The storytellers own their digital stories and provided consent to include them in ongoing dissemination efforts. In September 2021, a webpage was launched to house the stories, and this resource is being shared widely. Evaluation efforts of the webpage are ongoing to understand how these digital stories are being used to inform maternal health efforts. Digital stories add richness to ongoing maternal health prevention work and may serve as a powerful tool to elicit understanding among providers, practitioners, and constituents.
  Citation: Health Promotion Practice
  PubDate: 2023-04-11T05:44:15Z
  DOI: 10.1177/15248399231166422
Evaluation of a Brief Online Sexual Health Program for Adolescents: A
Randomized Controlled Trial
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  Authors: Jordyn McCrimmon, Laura Widman, Hannah Javidi, Julia Brasileiro, Jeffrey Hurst
  Abstract: Health Promotion Practice, Ahead of Print.
  Adolescents are at increased risk of acquiring sexually transmitted infections (STIs) and experiencing unintended pregnancy. In particular, adolescents from marginalized communities experience significant sexual health disparities compared to their more advantaged peers. Digital sexual health programs, such as HEART (Health Education and Relationship Training), may be effective in reducing these risks and addressing these disparities. HEART is a web-based intervention focused on the promotion of positive sexual health outcomes, such as sexual decision-making skills, sexual communication skills, sexual health knowledge, and sexual norms and attitudes. The current study evaluates the efficacy of HEART, and examines whether effects were moderated by gender, socioeconomic status (SES), race, English as a second language, and sexual orientation to ensure the program is effective for diverse groups of adolescents. Participants were 457 high school students (Meanage=15.06, 59% girls, 35% White, 78% heterosexual, 54% receive free or reduced-price lunch). Students were randomized to HEART or an attention matched control and assessed at pretest and immediate posttest. HEART was effective in increasing sexual assertiveness, sexual communication intentions, HIV/STI knowledge, condom attitudes, and safer sex self-efficacy compared to the control condition. There were no significant interactions by gender, SES, race, English as a second language, or sexual orientation, suggesting the program worked equally well for all groups of youth. The findings of this study suggest that HEART may be a promising avenue for the promotion of positive sexual health outcomes for diverse groups of youth.
  Citation: Health Promotion Practice
  PubDate: 2023-04-04T06:05:58Z
  DOI: 10.1177/15248399231162379
Toward a Politics of Care: Southeast Asian Refugee Organizing, Kinship,
Care, and Reunion
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  Authors: James Huỳnh, Victoria Huỳnh, mads lê, Sheila Sy
  Abstract: Health Promotion Practice, Ahead of Print.
  From a critical refugee studies orientation, our article redefines care within the context of myriad forms of state violence impacting Southeast Asian post-war refugee communities. Research reveals how harm is compounded at every step of Southeast Asian refugee journeys: war, forced displacement, resettlement, family separation, inherited health conditions, and generational trauma. How do we reckon with refugee trauma without conceding to it as an unchangeable fact of our lives' What knowledge might we gain by attending to the everyday work of survival in refugee communities' To answer these questions, the authors conceptualize care through (a) abolitionist organizing, (b) queer kinship and affective labor, (c) historiographic caretaking, and (d) refugee reunion.
  Citation: Health Promotion Practice
  PubDate: 2023-03-31T10:57:38Z
  DOI: 10.1177/15248399231164411
The Opioid Response Project: An Effective Learning Collaborative for Local
Communities'
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  Authors: Melanie Livet, Chloe Richard, Emily Williamson Gangi
  Abstract: Health Promotion Practice, Ahead of Print.
  The Opioid Response Project (ORP) was designed as an intensive 2-year health promotion learning collaborative grounded in the Collective Impact Model (CIM) to prepare ten local communities to address the opioid crisis. The purpose of this evaluation was to describe the ORP implementation, provide a summary of the evaluation results, share insights, and discuss implications. Results were informed by multiple data sources, including project documents, surveys, and interviews with members of the ORP and community teams. Based on process evaluation results, 100% of community teams reported being satisfied with the ORP and recommended this experience to others. ORP participation outputs ranged from new opioid response programs, to strengthened community teams, to receipt of additional funding. Based on the outcome evaluation, the ORP was effective at increasing community knowledge and capacity, promoting collaboration, and facilitating sustainability. This initiative is an example of an effective learning collaborative to curb the opioid epidemic at the community level. Participating communities found great value in working together as part of a larger cohort and reported benefits from the peer learning and support provided by the ORP. In particular, access to technical assistance, identification of engagement strategies within and across community teams, and a focus on sustainability are key practice components to be included in learning collaboratives designed to address large-scale public health issues.
  Citation: Health Promotion Practice
  PubDate: 2023-03-31T10:55:33Z
  DOI: 10.1177/15248399231162378
Creating a Narrative for Change: Health Promotion Students’ Perspectives
on the Power of Photovoice Research
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  Authors: Breanna De Leon, Fatawu Mahama, Ashley Raymond, Cheryl A Palmer, Jean M. Breny
  Abstract: Health Promotion Practice, Ahead of Print.
  The use of Critical Race Theory, Photovoice, and Community-Based Participatory Research has helped uncover the root causes of issues such as systemic racism in the fields of public health and health promotion. Often, we see studies using traditional research methods to investigate potential causal factors of disparities in minoritized communities report only quantitative data. While these data are imperative for understanding the severity of disparities, quantitative-only approaches cannot address nor can they improve the critical root causes of these disparities. As a team of BIPOC graduate students in public health, we conducted a community-based participatory research project using Photovoice methodology to explore inequities in Black and Brown communities exacerbated during the COVID-19 pandemic. The participatory nature of this research revealed cumulative challenges across the social determinants of health in New Haven and Bridgeport, Connecticut. It allowed us to engage in local-level advocacy to promote health equity as our findings illuminated the need for community-led and community-engaged action. Health and racial inequities cannot be effectively addressed if public health research and programming do not collaborate with the community to build community capacity, empowerment, and trust. We describe our experiences doing community-based participatory research to investigate inequities and provide reflections on their value for public health students. As responses to health inequities and disparities become more politically polarized in the United States, it is critical for public health and health education students to use research methodologies that elevate communities that have been historically marginalized and neglected. Together, we can catalyze equitable change.
  Citation: Health Promotion Practice
  PubDate: 2023-03-31T10:41:26Z
  DOI: 10.1177/15248399231162373
Pediatric Residents’ Outpatient Firearm Screening and Safety Counseling
Practices (Or Lack Thereof): A Retrospective Chart Review
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  Authors: Tyler Lennon, Jake Ruddy, Brittany Badesch, Christine Krueger, Barry Solomon, Katherine Hoops
  Abstract: Health Promotion Practice, Ahead of Print.
  The American Academy of Pediatrics recommends that children and adolescents be universally screened for access to firearms and exposure to violence. The purpose of this study was to characterize how often pediatric residents at one institution document screening for firearm access and violence risk factors and provide risk reduction counseling in the primary care setting. A retrospective chart review was conducted at two primary care clinics in Baltimore, Maryland, for patient ages 10 to 25 years who were seen by resident physicians for well care between October 2019 and December 2020. We reviewed 169 patients’ charts meeting the inclusion criteria. Forty (24%) patients had a documented history of exposure to violence or history of suicidal ideation. Based on resident documentation, one (
  Citation: Health Promotion Practice
  PubDate: 2023-03-30T01:18:29Z
  DOI: 10.1177/15248399231164909
Program Factors Affecting Weight Loss and Mobility in Older Adults:
Evidence From the Mobility and Vitality Lifestyle Program (MOVE UP)
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  Authors: Xinran Liu, Lori A. Kieffer, Jennifer King, Brandi Boak, Janice C. Zgibor, Kenneth J. Smith, Lora E. Burke, John M. Jakicic, Linda N. Semler, Michelle E. Danielson, Anne B. Newman, Elizabeth M. Venditti, Steven M. Albert
  Abstract: Health Promotion Practice, Ahead of Print.
  Background. The Mobility and Vitality Lifestyle Program (MOVE UP) is a behavioral weight-management intervention for improving mobility among community-dwelling older adults. We examined program factors that affect implementation outcomes and participant-level health outcomes. Methods. The MOVE UP program was implemented in the greater Pittsburgh area from January 2015 to June 2019 to improve lower extremity performance in community-dwelling older adults who were overweight or obese. Thirty-two sessions were delivered over 13 months. All sessions were designed to be 1-hour in length, on-site, group-based, and led by trained and supported community health workers (CHWs). Participants completed weekly Lifestyle Logs for self-monitoring of body weight, diet, and physical activity. We evaluated the MOVE UP program using the RE-AIM framework, and collected quantitative data at baseline, 5-, 9-, and 13-months. Multilevel linear regression models assessed the impacts of program factors (site, CHW, and participant characteristics) on implementation outcomes and participant-level health outcomes. Results. Twenty-two CHWs delivered MOVE UP program to 303 participants in 26 cohorts. Participants were similar to the target source population in weight but differed in some demographic characteristics. The program was effective for weight loss and lower extremity function in both intervention and maintenance periods (Ps < .01), with an independent effect for Lifestyle Logs submission but not session attendance. Discussion. CHWs were able to deliver a multi-component weight loss intervention effectively in community settings. CHW and site characteristics had independent impacts on participants’ adherence. Lifestyle Log submission may be a more potent measure of adherence in weight loss interventions than attendance.
  Citation: Health Promotion Practice
  PubDate: 2023-03-28T12:53:45Z
  DOI: 10.1177/15248399231162377
WITHDRAWAL—Administrative Duplicate Publication: Mural Painting to
Collect Sensitizing Data and Encourage Research Participation Among U.S.
Latinos
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  Abstract: Health Promotion Practice, Ahead of Print.
  
  Citation: Health Promotion Practice
  PubDate: 2023-03-24T09:51:11Z
  DOI: 10.1177/15248399231157343
Toitū te Tiriti: A Tiriti o Waitangi-led Approach to Public Health
Curriculum Development
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  Authors: Christina Severinsen, Bevan Erueti, Linda Murray, Suzanne Phibbs, Christine Roseveare, Charles Egwuba
  Abstract: Health Promotion Practice, Ahead of Print.
  At Te Kunenga ki Pūrehuroa (Massey University), Aotearoa New Zealand, we have declared our stance as a Te Tiriti o Waitangi-led institution. This necessitates the embodiment and enactment of the principles and provisions of Te Tiriti o Waitangi and the embedding of Indigenous Māori knowledge, values and belief systems in curriculum design and implementation. This article outlines the beginning of our journey toward indigenizing our postgraduate public health curriculum at Te Kunenga ki Pūrehuroa. We describe the redevelopment of the Master of Public Health curriculum that embeds mātauranga Māori (Māori knowledge), te reo Māori (Māori language), tikanga Māori (Māori values and belief systems), and Māori pedagogy (culturally sustaining teaching and learning practices). Here, we focus on how curriculum redevelopment and pedagogy have enabled the utility of Māori knowledge and processes to be reflected at every level of the program and give life and relevancy to Te Tiriti o Waitangi. Te Tiriti o Waitangi guides our teaching practice and ensures that students can safely develop their confidence in Māori ways of knowing, being, and doing to effectively partner with Māori as Tangata Whenua. Our program aims to produce agentic graduates who are champions and advocates for Māori aspirations in health.
  Citation: Health Promotion Practice
  PubDate: 2023-03-22T01:14:06Z
  DOI: 10.1177/15248399231163565
Pintura Mural para Recolectar Datos Sensibilizantes y Fomentar la
Participación en la Investigación Entre los Latinos de EE. UU
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  Authors: Adrienne Martinez-Hollingsworth, Jacqueline Hernández, Cristina Edwards, Keosha Partlow
  Abstract: Health Promotion Practice, Ahead of Print.
  Proposito. Describir una intervención de murales implementadas con comunidad envecindarios Latinos para elevar conciencia de barreras delreclutamiento/retención de Latinos en EE. UU. en la investigación clínica,y aumentar acceso de los investigadores a conceptos de sensibilización críticos para el riguroso diseño de estudios. Fondo. Latinos en EE. UU. sufren desproporcionada de varias enfermedadescrónicas, pero son subrepresentados como investigadores y participantesen investigaciones financiadas por Institutos Nacionales de Salud. Faltade representación inhibe conciencia de necesidades Latinas para la saludy obstaculiza esfuerzos para abordar la falta de equidad en comunidadesdiversas. Las intervenciones de arte en comunidades Latinas siguensiendo reconocidas por capacidad a cerrar brechas e incrementar lacalidad y cantidad de asociaciones de investigación entre investigadores y Latinos. Método. Este artículo describe una intervención de murales puesta a prueba endos vecindarios mayormente Latinos entre 2016 y 2020. El método deldiseño fue guiado por prácticas de investigación participativas con lacomunidad enfocadas en Evaluación-Diagnóstico Planificación- Implementación-Evaluación. Resultados. Los murales abordaron muchos desafíos de participación que a menudo se asocian con la subrepresentación de los Latinos en la investigación académica y permitió entrevistas de sensibilización con miembros clave de la comunidad sobre temas de interés para investigación. Conclusión. Los métodos de investigación que reconocen las formas de arte tradicionales, como murales, crean espacio para generar confianza e iniciar interés en la participación en investigaciones, y aumentan acceso
  Citation: Health Promotion Practice
  PubDate: 2023-03-22T01:13:00Z
  DOI: 10.1177/15248399231156609
Schools as a Source of Mental Health Literacy: Adjusting and Validating a
Mental Health Literacy Scale
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  Authors: Hanne Nissen Bjørnsen, Gunnar Bjørnebekk, Christian Brandmo
  Abstract: Health Promotion Practice, Ahead of Print.
  Over the last decade, there has been a growing interest in mental health literacy (MHL) in health promotion, largely motivated by increased awareness of MHL as a modifiable determinant of mental health. Accordingly, MHL has been associated with the health-promoting school approach emerging over the last 20 years. To succeed in promoting MHL, it is of vast importance to evaluate working strategies and interventions to address MHL using validated instruments. The current study describes the revision and psychometric testing of a modified version of the 10-item adolescents’ positive MHL measure, the MHPK-10, the only identified instrument measuring adolescents’ positive MHL. The MHPK-10 was adjusted to address the previously documented ceiling effects and was further optimized for use in schools by reworking it to measure learning rather than self-reported knowledge, becoming the new nine-item Mental Health Learning Scale (MHLS-9). The MHLS-9 was tested on a national sample of N = 2,012 Norwegian ninth graders. Data were analyzed by confirmatory factor analysis (CFA) and tests of reliability and validity. The revised CFA model for the MHLS-9 showed an improved fit over the original CFA model for the MHPK-10. The MHLS-9s’ CFA model revealed excellent factor determinacy (.95) and scale reliability (ω = .91). Thus, the MHLS-9 is an improved measure for the positive component of MHL for use in school settings, enabling researchers and practitioners to evaluate and focus positive MHL interventions in schools using a short, reliable, and valid measure for adolescents’ learning about the factors promoting good mental health.
  Citation: Health Promotion Practice
  PubDate: 2023-03-21T06:13:01Z
  DOI: 10.1177/15248399231161090
Physical Activity and Social Comparison: The Importance of Group
Composition in an Employee Fitbit Intervention
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  Authors: Jennifer R. Wentz, Sonja Wilhelm Stanis
  Abstract: Health Promotion Practice, Ahead of Print.
  This study examined the impact of group composition of a 6-week group-based employee Fitbit intervention on daily physical activity steps. Group composition comprised heterogenous and homogeneous groupings based on variations in baseline high, medium, and low steppers. The intervention included weekly step leaderboard information, motivational and informative messages, and the ability to participate in group step challenges. Repeated measures analysis of variance (ANOVA) examined differences in change of steps across time, step-level groups (low, medium, and high), and group composition (low/high, similar, and mixed), and replicated with a subgroup of participants who participated in group step challenges. While group and step level did not emerge as significant interactions in the overall sample, when focused within the group step challenge subsample, relationships among time, the group composition, and participant step-level categories emerged. Overall, the greatest increases in steps occurred at the mid-point time period, among lower steppers, and within the low/high comparison group. This study provides evidence of the importance of group composition in physical activity interventions as well as the fidelity of intervention design in facilitating group comparisons.
  Citation: Health Promotion Practice
  PubDate: 2023-03-18T06:53:05Z
  DOI: 10.1177/15248399231160152
Exploring Food and Nutrition Programming for People Living With HIV/AIDS:
Interviews With Service Providers in Nova Scotia, Canada
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  Authors: Abigail Clarke, Winta Tesfatsion, Jessica Mannette, Barbara-Ann Hamilton-Hinch, Patricia Williams, Shannan Grant, Phillip Joy
  Abstract: Health Promotion Practice, Ahead of Print.
  There is a lack of nutritional programming and resources available for people living with HIV/AIDS (PLWHA) in Nova Scotia, Canada. This is problematic for several reasons, including that adequate food and nutrition knowledge is integrated to effective medical therapy and wellness for PLWHA. The aim of this research was to explore and describe the beliefs, values, and experiences of HIV-service providers involved programming for PLWHA in Nova Scotia. Using a post-structuralist lens, semi-structured interviews were conducted with nine service providers. Thematic analysis of interview transcripts identified four main themes: (1) recognizing the social determinants of health, (2) acknowledging and disrupting layered stigma, (3) understanding the commensality, and (4) navigating and utilizing networks of care. These findings suggest that those developing, delivering, and evaluating food and nutrition-related programming must engage in community-inclusive approaches that recognize the varied social determinants of health that shape the lived of PLWHA, leverage existing networks and resources, and actively disrupt layered stigma. Also, in agreement with existing evidence, participants stressed the value of communicating and supporting the practice of eating together (commensality) and cultivating networks of care.
  Citation: Health Promotion Practice
  PubDate: 2023-03-17T12:30:28Z
  DOI: 10.1177/15248399231160758
Perceived Benefits and Barriers to Implementing Occupational Health
Recommendations Among Immigrant-Owned Nail Salons in the Greater
Philadelphia Region
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  Authors: Trân B Huỳnh, Dương (Tina) Nguyễn, Nga Vũ, Amy Carroll-Scott, Chanina Wong, Catherine Freeland, Claudia Parvanta
  Abstract: Health Promotion Practice, Ahead of Print.
  Introduction. Immigrant nail salon owners and employees face multiple barriers to accessing occupational health training and services. We formed an academic-community-based organization–business owner partnership—unique in that all partners were culturally congruent—to develop a pilot intervention program for the nail salon community. Methods. Eighteen individuals (nine salon owners and nine employees) from the Greater Philadelphia region received the training in their native language and provided feedback through in-depth qualitative interviews. Interview guide was developed using the Consolidated Framework for Implementation Research (CFIR). Themes of perceived benefits and barriers were identified and aligned with relevant CFIR constructs to gain better understanding of the implementation challenges. Results. Reported benefits of program were improved knowledge of the workplace hazards and safety practices, and the potential to attract more customers and retain employees. Perceived barriers to implementing recommended practices were limited availability of safer products and high cost, challenges communicating with customers, lack of engagement from some owners, organizational management practices affecting employees’ motivation, and limited partnership with local government to assist small immigrant-owned businesses. Conclusions. Our study revealed multiple factors that pit long-term health protection of nail salon workers against the economic viability of the businesses that employ them. Our research highlights the need to (1) advocate for federal policies making safer products to be more accessible to the masses, (2) establish local policy and culturally appropriate technical support programs that engage community-based organizations, and (3) develop economic opportunities and mentorship for immigrant entrepreneurs to operate profitable healthy salons.
  Citation: Health Promotion Practice
  PubDate: 2023-03-16T09:28:45Z
  DOI: 10.1177/15248399231160461
Formative Research to Inform College Health Communication Campaigns About
COVID-19 Prevention Behaviors
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  Authors: Holli H. Seitz, Antonio J. Gardner, Leah B. P. Pylate
  Abstract: Health Promotion Practice, Ahead of Print.
  This research aimed to inform the development of a health communication campaign to increase the uptake of COVID-19 prevention behaviors among university students. Twenty-eight students attending a mid-sized public university in the southeastern United States and 84 parents or guardians of university students were recruited. The study included an online survey assessing COVID-19 prevention behaviors, perceived susceptibility to COVID-19, perceived severity of COVID-19, and semi-structured interviews to elicit beliefs on COVID-19 prevention behaviors. Students and parents/guardians reported that getting COVID-19 was possible but not necessarily likely. COVID-19 was seen as serious and at least somewhat severe. Dominant interview themes for benefits, barriers, response efficacy, and self-efficacy related to prevention behaviors are reported. Overall, perceptions of behavioral benefits, barriers, and response efficacy were often shared by parents and students but varied across behaviors. These data provide insights for future campaign development for the control of infectious diseases among college students.
  Citation: Health Promotion Practice
  PubDate: 2023-03-15T06:55:01Z
  DOI: 10.1177/15248399231160768
Perceived Health Needs of Church Leaders and Members: A Secondary Data
Analysis of the Mid-South Congregational Health Survey
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  Authors: Nathan T. West, Latrice C. Pichon, Kenneth D. Ward, Emily Rose N. San Diego, Meredith Ray, Fedoria Rugless, Terrinieka W. Powell, Bettina Campbell, Jonathan C. Lewis, Lauren McCann, Sterling McNeal, Brook E. Harmon
  Abstract: Health Promotion Practice, Ahead of Print.
  Needs assessments have been successful in helping communities and congregations focus their health ministry efforts; however, most have used leader perceptions of congregational health needs. The purpose of this study was to examine and compare the self-reported needs of both church leaders and members to be addressed by their congregation. Church leaders (n = 369) and members (n = 459) from 92 congregations completed the 2019 Mid-South Congregational Health Survey. Frequencies and generalized linear mixed models (GLMM) were performed to examine the top 10 self-reported needs and associations by church role, respectively. Of the top 10 congregational needs, anxiety or depression, high blood pressure, stress, and healthy foods were ranked identically regardless of church role. Church leaders perceived obesity and diabetes to be important congregational health needs, whereas members perceived affordable health care and heart disease to be important congregational health needs. GLMM, controlling for within-church clustering and covariates, revealed church leaders were more likely than members to report obesity (odds ratio [OR]: 1.93, 95% confidence interval [CI] = [1.39, 2.67], p < .0001) and diabetes (OR: 1.73, 95% CI = [1.24, 2.41], p = .001) as congregational needs. Findings display similarities and differences in needs reported by church role. Including many perspectives when conducting congregational health needs assessments will assist the development of effective faith-based health promotion programs.
  Citation: Health Promotion Practice
  PubDate: 2023-03-15T06:52:42Z
  DOI: 10.1177/15248399231160158
A Model of Stakeholder Engagement with American Indians and Alaska Natives
from the Native-CHART Study
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  Authors: Tassy Parker, Norman James Cooeyate, Nathania Tsosie, Allyson Kelley
  Abstract: Health Promotion Practice, Ahead of Print.
  American Indian (AI) and Alaska Native (AN) community stakeholder engagement has the power to transform health research. However, the engagement and dissemination process is challenging in AIAN communities due to the historical and current negative experiences of AIAN populations in health research (Dillard et al., 2018). Whereas there is a paucity of recommendations about how to engage stakeholders in health research, from agenda-setting to proposal development, study design, recruitment, data collection, analysis, results, and dissemination (Concannon et al., 2014), there is limited information about how these recommendations are operationalized within the context of AIAN health research and practice (Concannon et al., 2014; Forsythe et al., 2016). For the purposes of this article, stakeholders are individuals, organizations, or communities who have a direct interest in the process and outcomes of a project, research, or policy effort (Boaz et al., 2018). Stakeholder engagement is a systematic process involving stakeholders, which provides opportunities for consultation, input, reviews, reactions, support, and assistance with dissemination. Dissemination focuses on how, when, by whom, and under what circumstances evidence spreads throughout agencies, organizations, states, counties, communities, tribes, researchers, policy makers, and service organizations.
  Citation: Health Promotion Practice
  PubDate: 2023-03-13T10:41:41Z
  DOI: 10.1177/15248399231160563
Public Health Training Centers: More Relevant Than Ever
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  Authors: Matthew Fifolt, Lisa C. McCormick, Melissa Alperin
  Abstract: Health Promotion Practice, Ahead of Print.
  Interest in and awareness of public health in the United States has grown due to COVID-19; however, state and local health departments have seen a mass exodus of leadership since the beginning of the pandemic. Based on the results of the de Beaumont Foundation’s most recent Public Health Workforce Interests and Needs Survey (PH WINS), nearly one in three public health employees say they are considering leaving the profession due to stress, burnout, and low pay. One viable strategy for ensuring a diverse and competent public health workforce is the national network of Public Health Training Centers (PHTCs). This commentary describes the Public Health Training Center Network, with a specific focus on Region IV, and discusses challenges and opportunities for advancing the public health agenda in the United States. The national PHTC Network continues to provide invaluable services in terms of training, professional development, and experiential learning for the current and future public health workforce. However, increased funding would allow PHTCs to have a greater impact and reach through bridge programs for public health workers and others, additional field placement experiences, and expanded outreach to non-public health professionals in training activities. PHTCs have shown great adaptability over time and can once again pivot to meet the needs of a rapidly changing public health landscape demonstrating that PHTCs are truly more relevant than ever.
  Citation: Health Promotion Practice
  PubDate: 2023-03-06T12:55:06Z
  DOI: 10.1177/15248399231160144
New Collaborative Research on Suicide Prevention, Practice, and Policy
With American Indian and Alaska Native Communities Holds Promise for All
Peoples
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  Authors: A. Barlow, E. E. Haroz, V. M. O’Keefe, T. Brockie, S. M. Manson, J. Allen, L. Wexler, D. Buchwald, S. Rasmus, N. Goklish, J. Ivanich, M. Stifter, M. Cwik
  Abstract: Health Promotion Practice, Ahead of Print.
  Youth suicide is increasing in the United States, with deaths among younger people of color driving this upward trend. For more than four decades, American Indian and Alaska Native (AIAN) communities have suffered disproportionate rates of youth suicide and years of productive life lost compared to other U.S. Races. The National Institute of Mental Health (NIMH) recently funded three regional Collaborative Hubs to carry out suicide prevention research, practice, and policy development with AIAN communities in Alaska and rural and urban areas of the Southwestern United States. The Hub partnerships are supporting a diverse array of tribally-driven studies, approaches, and policies with immediate value for increasing empirically driven public health strategies to address youth suicide. We discuss unique features of the cross-Hub work, including: (a) long-standing Community-Based Participatory Research processes that led to the Hubs’ innovative designs and novel approaches to suicide prevention and evaluation, (b) comprehensive ecological theoretical approaches that contextualize individual risk and protective factors in multilevel social contexts; (c) unique task-shifting and systems of care approaches to increase reach and impact on youth suicide in low-resource settings; and (d) prioritization of strengths-based approaches. The work of the Collaborative Hubs for AIAN youth suicide prevention is generating specific and substantive implications for practice, policy, and research presented in this article at a time when youth suicide prevention is a dire national priority. Approaches also have relevance for historically marginalized communities worldwide.
  Citation: Health Promotion Practice
  PubDate: 2023-03-03T01:39:14Z
  DOI: 10.1177/15248399221116630
Immigration Policy is Health Policy: News Media Effects on Health
Disparities for Latinx Immigrant and Indigenous Groups
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  Authors: Mario Espinoza-Kulick, Alex Espinoza-Kulick, Elisa González, Jodene Takahashi
  Abstract: Health Promotion Practice, Ahead of Print.
  Legal exclusions and cultural factors reproduce barriers to health care by enforcing boundaries between citizens and immigrants, leading to a range of health risks and disparities for Latinx immigrant and Indigenous communities. This study utilized a mixed-methods examination of news media and ethnographic interviews guided by a decolonial-inspired framework to demonstrate the linkages between policy discourse and health behaviors. Both newspaper articles and interviews with affected stakeholders show how immigrants and their families experience more significant health risks because of policy changes and proposals. Regardless of the political regime, media discourses that promote fear and threat sustain the overall effects of immigration policy enforcement strategies on health. Immigration policy is health policy, and these laws should be evaluated in terms of their impact on public health, in addition to other factors. Furthermore, the news media is a contextual factor for health promotion strategies and a target for health advocates working with immigrant and Indigenous communities.
  Citation: Health Promotion Practice
  PubDate: 2023-03-01T11:46:24Z
  DOI: 10.1177/15248399221150816
Developing and Evaluating a School-Based Tobacco and E-Cigarette
Prevention Program for Deaf and Hard-of-Hearing Youth
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  Authors: Alison K. Herrmann, Burton Cowgill, Debra Guthmann, Jessica Richardson, L. Cindy Chang, Catherine M. Crespi, Everett Glenn, Michael McKee, Barbara Berman
  Abstract: Health Promotion Practice, Ahead of Print.
  School-based programs are an important tobacco prevention tool. Yet, existing programs are not suitable for Deaf and Hard-of-Hearing (DHH) youth. Moreover, little research has examined the use of the full range of tobacco products and related knowledge in this group. To address this gap and inform development of a school-based tobacco prevention program for this population, we conducted a pilot study among DHH middle school (MS) and high school (HS) students attending Schools for the Deaf and mainstream schools in California (n = 114). American Sign Language (ASL) administered surveys, before and after receipt of a draft curriculum delivered by health or physical education teachers, assessed product use and tobacco knowledge. Thirty-five percent of students reported exposure to tobacco products at home, including cigarettes (19%) and e-cigarettes (15%). Tobacco knowledge at baseline was limited; 35% of students knew e-cigarettes contain nicotine, and 56% were aware vaping is prohibited on school grounds. Current product use was reported by 16% of students, most commonly e-cigarettes (12%) and cigarettes (10%); overall, 7% of students reported dual use. Use was greater among HS versus MS students. Changes in student knowledge following program delivery included increased understanding of harmful chemicals in tobacco products, including nicotine in e-cigarettes. Post-program debriefings with teachers yielded specific recommendations for modifications to better meet the educational needs of DHH students. Findings based on student and teacher feedback will guide curriculum development and inform next steps in our program of research aimed to prevent tobacco use in this vulnerable and heretofore understudied population group.
  Citation: Health Promotion Practice
  PubDate: 2023-02-10T05:44:11Z
  DOI: 10.1177/15248399221151180
Kenya’s Experience: Factors Enabling and Impeding the COVID-19
Response
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  Authors: Jemimah Mwakisha, Ben Adika, Susan Nyawade, Peter Malekele Phori, Noemie Nikiema Nidjergou, Cleph Silouakadila, Stephen Fawcett
  Abstract: Health Promotion Practice, Ahead of Print.
  This case study describes the country-level response to the COVID-19 pandemic in Kenya between February 2020 and May 2021. We organize the presentation of COVID-19 response strategies across the five stages of (a) engagement, (b) assessment, (c) planning, (d) action/implementation, and (e) evaluation. We describe the participatory monitoring and evaluation (M&E) process implemented in collaboration with the WHO Regional Office for Africa Monitoring and Evaluation Team. The M&E system was used to organize and make sense of emerging data regarding specific response activities and changing COVID incidence. We share the results of that collaborative sensemaking, with particular attention to our analysis of the factors that facilitated and those that impeded our pandemic response. We conclude with lessons learned and practical implications from Kenya’s experience to help guide future country-level responses to rapidly changing public health crises.
  Citation: Health Promotion Practice
  PubDate: 2023-02-03T11:05:49Z
  DOI: 10.1177/15248399221117566
The Cost of Diversity: An Analysis of Representation and Cost Barriers in
Stock Photo Libraries for Health Education Materials, 2021
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  Authors: Zachary A. Chichester, Michelle A. Jewell, Catherine E. LePrevost, Joseph G. L. Lee
  Abstract: Health Promotion Practice, Ahead of Print.
  Introduction. Ineffective health communication can drive health disparities and limit the effectiveness of interventions to reduce them. Stock photo libraries are a critical tool for developers of patient education, health education, and intervention materials. It is not clear how well stock photo libraries represent communities bearing disproportionate burdens of disease. Method. We conducted a search using five popular stock image libraries (Adobe Stock Images, Canva, Getty Images, Microsoft Office Image Library, and Pixabay) in November 2021 to evaluate diversity and representation in health-related stock photos. We searched for the following five key preventive health topics: healthy eating, exercising, quitting smoking, vaccination, and pregnancy. The images (N = 495) were coded for age, gender presentation, representation of perceived minoritized racial/ethnic identity, skin color using the Massey–Martin skin color scale, markers of high socioeconomic status (SES), and access costs. Results. The representation of perceived minoritized people, darker skin color, and inclusion of markers of high SES varied greatly by the search term and library. Images predominately portrayed young adults and adults, with limited representation of other age groups. Images in libraries with any paywall were significantly more likely to depict a person of perceived minoritized racial/ethnic identity and depict darker skin colors, and were significantly less likely to contain markers of high SES identity than images in libraries that were free to use. Discussion. We found that it costs more to develop culturally relevant health education materials for minoritized populations and groups that do not represent high SES populations. This may hinder the development of effective communication interventions.
  Citation: Health Promotion Practice
  PubDate: 2023-02-01T09:07:02Z
  DOI: 10.1177/15248399221150788
Understanding Physical Distancing and Face Mask Use Across High-Risk
African American Subgroups During the COVID-19 Pandemic: Application of
Health Belief Model
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  Authors: Jamal Moss, Leah Alexander, Iman Barré, Imari Parham, Taneisha Gillyard, Jamaine Davis, Jennifer Cunningham-Erves
  Abstract: Health Promotion Practice, Ahead of Print.
  Physical distancing and face masks remain frontline prevention strategies due to suboptimal vaccine uptake and the highly infectious COVID-19 variants. Communities of color are disproportionately impacted by a chronic disease burden that places them at higher risk of severe COVID-19 disease. Therefore, they can greatly benefit from face mask use and physical distancing, especially if the individual(s) have not received the vaccine. We applied the Health Belief Model to explore barriers and motivators influencing physical distancing and face mask use among high-risk, Black American subgroups during the early COVID-19 pandemic stages. We conducted 62 semi-structured interviews among four Black American subgroups: young adults, individuals with underlying medical conditions, essential workers, and parents. Thematic analysis, guided by the Health Belief Model, yielded six themes: (1) Knowledge on Face Mask Use and Physical Distancing, (2) Perceived Susceptibility and Severity Varies by Subgroup, (3) Experience with and Perceived Self-Efficacy to Engage in Preventive Behavior, (4) Perceived Benefits to engaging in preventive behaviors, (5) Perceived Barriers to engage in preventive behaviors, and (6) Cues to action to increase participation. Each subgroup’s unique experience informed multilevel, tailored approaches that can be used by health promotion practitioners to improve face mask use and physical distancing among uniquely vulnerable Black American subgroups in the current and future pandemic.
  Citation: Health Promotion Practice
  PubDate: 2023-01-30T06:22:53Z
  DOI: 10.1177/15248399221151176
A Community Participatory Approach to Creating Contextually Tailored
mHealth Notifications: myBPmyLife Project
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  Authors: Abby Katherine Hellem, Amanda Casetti, Kaitlyn Bowie, Jessica R. Golbus, Beza Merid, Brahmajee K. Nallamothu, Michael P. Dorsch, Mark W. Newman, Lesli Skolarus
  Abstract: Health Promotion Practice, Ahead of Print.
  Just-in-time adaptive interventions (JITAIs) are a novel approach to mobile health (mHealth) interventions, sending contextually tailored behavior change notifications to participants when they are more likely to engage, determined by data from wearable devices. We describe a community participatory approach to JITAI notification development for the myBPmyLife Project, a JITAI focused on decreasing sodium consumption and increasing physical activity to reduce blood pressure. Eighty-six participants were interviewed, 50 at a federally qualified health center (FQHC) and 36 at a university clinic. Participants were asked to provide encouraging physical activity and low-sodium diet notifications and provided feedback on researcher-generated notifications to inform revisions. Participant notifications were thematically analyzed using an inductive approach. Participants noted challenging vocabulary, phrasing, and culturally incongruent suggestions in some of the researcher-generated notifications. Community-generated notifications were more direct, used colloquial language, and contained themes of grace. The FQHC participants’ notifications expressed more compassion, religiosity, and addressed health-related social needs. University clinic participants’ notifications frequently focused on office environments. In summary, our participatory approach to notification development embedded a distinctive community voice within our notifications. Our approach may be generalizable to other communities and serve as a model to create tailored mHealth notifications to their focus population.
  Citation: Health Promotion Practice
  PubDate: 2023-01-27T09:08:13Z
  DOI: 10.1177/15248399221141687
Using a Community-Informed Translational Model to Prioritize Translational
Benefits in Youth Concussion Return-to-Learn Programs
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  Authors: Julian Takagi-Stewart, Aspen Avery, Shyam J. Deshpande, Stephanie Andersen, Todd Combs, Monica S. Vavilala, Laura Prater
  Abstract: Health Promotion Practice, Ahead of Print.
  BackgroundThe Translational Science Benefit Model (TSBM) was developed to broadly capture systematic measures of health and societal benefits from scientific research, beyond traditional outcome measures. We aimed to develop a systematic process for the application of the TSBM and to then provide an example of a novel application of the TSBM to an ongoing Return-to-Learn (RTL) after youth concussion project involving partnerships with community stakeholders.MethodsWe invited investigators, project advisory board, and participants of the RTL project to participate in a modified Delphi process. We first generated a list of potential translational benefits using the indicators of the TSBM as guideposts. We then prioritized the benefits on an adapted Eisenhower matrix.ResultsWe invited 35 concussion care or research experts to participate, yielding 20 ranked translational benefits. Six of these recommendations were ranked high priority, six were regarded as investments, and eight were ranked as either low yield or low priority.DiscussionThis study found that activities such as education and training of stakeholders, development of policy and consensus statements, and innovation in dissemination, were perceived as higher priority than other activities. Our approach using a modified Delphi process and incorporating the TSBM can be replicated to generate and prioritize potential benefits to society from research studies.
  Citation: Health Promotion Practice
  PubDate: 2023-01-27T06:03:08Z
  DOI: 10.1177/15248399221150911
“We’re Here to Take Care of Our Community”: Lessons Learned From the
U.S. Federal Health Center Covid-19 Vaccine Program
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  Authors: Johanna T. Crane, Rachel Fabi, Danielle Pacia, Carolyn P. Neuhaus, Nancy Berlinger
  Abstract: Health Promotion Practice, Ahead of Print.
  Equitable access to vaccination is crucial to mitigating the disproportionate impact of Covid-19 on low-income communities and people of color in the United States. As primary care clinics for medically underserved patients, Federally Qualified Health Centers (FQHCs) emerged as a success story in the national effort to vaccinate the U.S. public against Covid-19. In February 2021, the Federal Health Center Covid-19 Vaccine Program began allocating vaccine supply directly to FQHCs in an effort to improve vaccine equity. This qualitative study documents how FQHCs in two states successfully mitigated barriers to vaccine access, responded to patient concerns about vaccination, and worked to maintain and grow community trust in a climate of uncertainty and fear during early vaccine roll-out to the general population. Using a socio-ecological model, we show how FQHCs intervened at multiple levels to advance vaccine equity, revealing valuable lessons for health promotion practice in primary care settings or underserved communities. Our findings provide descriptive context for existing quantitative evidence showing FQHCs’ greater success in vaccinating people of color, and foreground valuable and innovative strategies for trustworthy health communication practices and equitable resource allocation to medically underserved patients and populations.
  Citation: Health Promotion Practice
  PubDate: 2023-01-23T10:52:03Z
  DOI: 10.1177/15248399221151178
Grounding the Work of Grassroots MCH Leaders in Storytelling
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  Authors: Ashley Irby, Erin Macey, Naomi Levine, Jenna Rae Durham, Jack E. Turman
  Abstract: Health Promotion Practice, Ahead of Print.
  Our Grassroots Maternal and Child Health (MCH) Initiative works to build the capacity of individuals and organizations in zip codes with persistently high infant mortality rates to bring about systems change that will improve maternal and child health (MCH) outcomes. Foundational to the Initiative is the training and mentoring of local women to become Grassroots MCH Leaders. We greatly honor that these women possess community expertise, essential to the Initiative’s success. Our training equips them with strategies they can use to bring about changes in social, economic, political, and/or cultural systems that underlie poor birth outcomes. One impactful strategy they learn is the use of critical narrative intervention (CNI). This approach, grounded in the crafting and sharing of stories, complements statistical, behavioral, and medical approaches to improve MCH outcomes. This article describes the impact of CNI within the Grassroots MCH Initiative. Drawing from 14 Grassroots MCH Leaders’ narratives, we present five significant maternal traumas and influential supports in their surrounding contexts. We explore the leaders’ reflections on the impact of story development and dissemination. Our findings reveal that situating CNI within the context of a grassroots initiative provides opportunities for leaders to use their stories to advocate for systems change. Personal MCH narratives provide a powerful and respectful approach to public health promotion, as they highlight important systems-level failures that need to be addressed to sustainability improve MCH outcomes.
  Citation: Health Promotion Practice
  PubDate: 2023-01-23T10:50:04Z
  DOI: 10.1177/15248399221151175
Group-Based Medical Mistrust in Adolescents With Poorly Controlled Asthma
Living in Rural Areas
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  Authors: Sarah I. Leonard, Connor T. Pizii, Yihong Zhao, Amarilis Céspedes, Sharon Kingston, Jean-Marie Bruzzese
  Abstract: Health Promotion Practice, Ahead of Print.
  Black youth and rural adolescents are two groups who experience asthma disparities. Racism and discrimination in health care likely lead to group-based (systems-level) medical mistrust for some adolescents. Group-based medical mistrust, one pathway by which racism drives health inequities, is associated with poorer outcomes for patients with chronic conditions. Despite its potential importance in adolescent asthma, previous research has not considered group-based medical mistrust in this population. To fill this gap, we characterize group-based medical mistrust among rural adolescents with poorly controlled asthma, examining demographic differences. We analyzed baseline data from a school-based clinical trial in which 164 adolescents (mean age = 16.3; 76.2% Black) completed the Group-Based Medical Mistrust Scale (GBMMS). Using linear regression, we tested associations with race, gender, and age, controlling for recent medical visits and insurance status. The total GBMMS mean score was 2.3 (SD = 1.22); subscale scores ranged from 2.3 to 2.4. Black adolescents reported significantly higher total GBMMS scores (β = .45, p = .003) and significantly higher scores on two GBMMS subscales: suspicion of health care providers (β = .56, p = .007) and lack of support from health care providers (β = .36, p = .007). Gender and age were not associated with GBMMS scores. Health care providers need to consider medical mistrust and its role in their clinical care. Together with their institutions, health care providers and researchers should work toward changing systems that perpetuate racism to build trust as a means of reducing asthma disparities among adolescents.
  Citation: Health Promotion Practice
  PubDate: 2023-01-19T11:37:36Z
  DOI: 10.1177/15248399221150913
Inoculating Black/African American and LGBTQ Communities Against the
Tobacco Industry: The Role of Community Connectedness and Tobacco
Denormalization Beliefs
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  Authors: Christopher W. Wheldon, Chris Skurka, Nicholas Eng
  Abstract: Health Promotion Practice, Ahead of Print.
  The purpose of this study was to explore how connectedness to Black/African American or lesbian, gay, bisexual, transgender and queer (LGBTQ) communities can promote anti-tobacco industry beliefs and to examine the role of targeted anti-tobacco industry messaging (i.e., tobacco industry denormalization [TID] messages).We hypothesized that community connectedness would predict anti-tobacco industry motivation (H1) and that this effect would be mediated by community-specific anti-industry beliefs (H2). We also hypothesized that these effects would be greater (i.e., moderated) for individuals exposed to targeted TID messages (H3). This study was a secondary analysis of data from a web-based experiment focused on the effects of counter-industry messages (data collected in 2020). The sample consisted of 430 Black/African Americans and 458 LGBTQ young adults. Hypotheses were tested using structural equation modeling. In support of hypothesis 1, community connectedness was associated with anti-tobacco industry motivation for both the LGBTQ and Black/African American subsamples. Hypothesis 2 was also supported. The associations between community connectedness and anti-industry motivations were partially mediated by anti-industry beliefs. Hypothesis 3 was not supported. Exposure to counter-industry messages did not modify the structural model; however, counter-industry messages increased anti-industry beliefs in both subsamples. Fostering community connectedness may help to mobilize community-based tobacco control efforts. Furthermore, interventions targeting anti-tobacco industry beliefs may be effective at reducing tobacco-related disparities. Anti-tobacco industry beliefs can be increased using brief targeted TID messages. Collectively, these findings suggest that community-based approaches rooted in consciousness-raising action may provide a useful model for future tobacco control interventions.
  Citation: Health Promotion Practice
  PubDate: 2023-01-17T11:49:20Z
  DOI: 10.1177/15248399221146553
Distracted and Impaired Driving Among U.S. Adolescents, 2019, USA
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  Authors: R. Andrew Yockey, Tracey E. Barnett
  Abstract: Health Promotion Practice, Ahead of Print.
  Distracted driving, the act of focusing on something else while operating a vehicle, is a significant health problem among adolescents. Although some studies have reported on prevalence among adolescents in the United States, limited studies have examined differences by sexual identity status. The purpose of the present study was to examine past 30-day distracted driving by sexual identity status among a large, national sample of adolescents ages 14 to 18 years. A secondary analysis was conducted on the 2019 Youth Risk Behavioral Surveillance System (YRBSS) data, and associations between distracted driving and demographics (e.g., biological sex, age, race/ethnicity) were assessed with weighted logistic regression analyses. A total of 13,590 adolescents ages 14 to 18 years were part of the final analytic sample. Twenty-three percent of adolescents reported distracted driving in the past 30 days. Compared with heterosexual adolescents, gay/lesbian (14.3%), bisexual (18.1%), and questioning (12.9%) adolescents reported lower distracted driving in the past 30 days. Findings through a health equity approach may inform harm reduction efforts and behavioral interventions.
  Citation: Health Promotion Practice
  PubDate: 2023-01-13T05:17:58Z
  DOI: 10.1177/15248399221150814
A Worksite Health Promoting Program for Early Head Start and Head Start
Workforce
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  Authors: Alma D. Guerrero, Ariella Herman
  Abstract: Health Promotion Practice, Ahead of Print.
  Introduction:Early Head Start (EHS) and Head Start (HS) staff comprise a large segment of the public sector workforce and experience numerous risk and chronic factors for medical conditions or symptoms. Few health and wellness workplace interventions, however, specifically focus on EHS/HS staff.Methods:A train-the-trainer (TTT) approach was used to build capacity among directors and staff from 57 EHS/HS programs on how to strategically plan and implement a health promoting worksite program focusing on improving nutrition and physical activity practices among EHS/HS staff. Baseline and 3-month post-training questionnaires assessed EHS/HS staff changes on knowledge and practices related to nutrition and physical activity. Paired t-tests or chi2 statistics assessed changes in questionnaire responses over time.Results:1,363 staff from 57 programs completed baseline and follow-up surveys. Staff had high knowledge regarding healthful dietary patterns at baseline. Over one-third of staff reported drinking soda with meals and almost 50% identified soda as their most common drink. Roughly one-third of staff also reported no physical activity in the prior week at baseline. Staff demonstrated significant improvements in dietary, nutrition, and physical activity practices. Staff also improved grocery shopping behaviors.Implications for Practice:The TTT approach to disseminate an EHS/HS staff-focused health promotion program, “Eat Healthy, Stay Active!’ provides a potentially promising strategy to build upon and disseminate more broadly to reach the over>300,000 EHS/HS staff workforce.
  Citation: Health Promotion Practice
  PubDate: 2023-01-13T05:13:18Z
  DOI: 10.1177/15248399221142897
Effectiveness of a Breast Cancer Education Screening and NavigaTion (BEST)
Intervention among Hispanic Women
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  Authors: Jennifer C. Molokwu, Alok Dwivedi, Adam Alomari, Navkiran Shokar
  Abstract: Health Promotion Practice, Ahead of Print.
  BackgroundIn the United States, breast cancer remains one of the most diagnosed cancers among females and remains the second leading cause of cancer death. In addition, breast cancer is most likely diagnosed at an advanced stage among Hispanic females in the United States due to lower mammogram utilization.AimsThe objective of this study was to determine the effectiveness of a multilevel, multicomponent community-based breast cancer screening intervention called the Breast Cancer Education Screening and NavigaTion (BEST) program. The primary outcome was the completion of a screening mammogram 4 months post-intervention.MethodWe used a pragmatic approach for evaluation, utilizing a quasi-experimental delayed intervention design. We recruited women from the community aged between 50 and 75, uninsured or underinsured, and overdue for screening.ResultsSix hundred participants were recruited (300 intervention and 300 control). Among completers, the screening rate was 97% in the intervention group and 4.4% in the control group (RR = 22.2, 95% CI: 12.5–39.7, p < .001). In multivariable analysis, age ≥ 65 (RR = 1.29, p = .047), perceived benefits (RR = 1.04, p = .026), curability (RR = 1.24, p < .001), subjective norms (RR = 1.14, p = .014), and fatalism (RR = .96, p = .004) remained significantly associated with screening outcome.ConclusionA multicomponent, bilingual, and culturally tailored intervention effectively facilitated breast cancer screening completion in an underserved population of Hispanic women. Individuals with improved screening outcomes were more likely to have higher positive beliefs. Our study has important implications regarding using multicomponent interventions in increasing breast cancer screening completion in poorly screened populations. It also highlights differences in health belief motivation for breast cancer screening completion.
  Citation: Health Promotion Practice
  PubDate: 2023-01-13T05:10:59Z
  DOI: 10.1177/15248399221135762
Charitable Pharmacies as Catalysts for Coordinated Care: Pharmacist
Management of Blood Glucose Among Under-Resourced Patients With Type 2
Diabetes
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  Authors: Jennifer Langhinrichsen-Rohling, Fallon Richie, Marlena Kelley, Candice Selwyn, Shearie Archer, Emily Blejwas
  Abstract: Health Promotion Practice, Ahead of Print.
  This community-academic-pharmacy partnership evaluated the impact of a pharmacist-led approach to diabetes management in under-resourced charitable pharmacy patients. Charitable pharmacies serve a large volume of under-resourced patients; pharmacist involvement may improve blood glucose management due to the frequency with which patients access the pharmacy for medications. The purpose of this study was to examine the impact of a pharmacist-led approach to diabetes management (measured by blood glucose levels) by providing medication therapy management (MTM) and leveraging communication between the pharmacist and patients’ primary care providers (PCPs). Study participants were Federally Qualified Health Center (FQHC) patients with type 2 diabetes who obtained free diabetes-related medications from the pharmacy. Participants were randomly assigned to treatment as usual (TAU), MTM, or MTM plus coordinated care between the pharmacist and the patient’s PCP. The blood glucose levels of patients who received MTM remained stable throughout the duration of the study while blood glucose levels for TAU patients significantly increased. A previously non-existent communication channel between pharmacists and FQHC providers was established and recommendations were exchanged. This relatively small investment on behalf of the pharmacy (e.g., routinely checking blood glucose, sharing medication recommendations) led to a return on health outcomes for a high-risk, low-resource patient population. This study yielded a beneficial change in practice as the pharmacy has institutionalized measuring at-risk patients’ blood glucose levels during pharmacy visits. The pharmacy has also continued to enhance their relationship with the FQHC to provide integrated, patient-centered care to this shared vulnerable patient population.
  Citation: Health Promotion Practice
  PubDate: 2023-01-11T05:14:09Z
  DOI: 10.1177/15248399221115082
A Collaborative Pilot to Support Patients With Diabetes Through Tailored
Food Box Home Delivery
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  Authors: Sarah Kempainen, Diana B. Cutts, Ramona Robinson-O’Brien, Alexandra De Kesel Lofthus, David T. Gilbertson, Rebecca Mino
  Abstract: Health Promotion Practice, Ahead of Print.
  We conducted a randomized, controlled prospective pilot study to determine feasibility and impact of food bank and health system collaboration to home-delivered food to adults with type 2 diabetes mellitus experiencing food insecurity. Treatment group received biweekly, ethnically tailored, home-delivered food for 24 weeks. Analysis included intervention feasibility and impact on healthcare utilization, HbA1c, and other health-related measures. Intervention was feasible and successful with high levels of participant satisfaction. At baseline, participants with highest HbA1c reported poorer health, lower medication adherence and self-care, and higher diabetes distress and medicine for food tradeoffs. At 24 weeks, treatment group reported improved food security and health status. There were no differences in HbA1c or healthcare utilization measures between the two groups. It is feasible for a community food bank and nearby hospital to successfully collaborate and provide supplemental food staples to food insecure adults with type 2 diabetes and improve food insecurity and health status. Public policy efforts should utilize and expand this strategy with the goal of improving health and reducing health disparities. Future work could include more comprehensive food support focused on those with poorest glycemic control, and expanded, coordinated interventions directed at other social determinants of health. Future programming and policies should be cocreated with community input to ensure greatest success.
  Citation: Health Promotion Practice
  PubDate: 2023-01-11T05:12:10Z
  DOI: 10.1177/15248399221100792
COVID-19 Disparities Among Arab, Middle Eastern, and West Asian
Populations in Toronto: Implications for Improving Health Equity Among
Middle Eastern and North African Communities in the United States
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  Authors: Mienah Z. Sharif, Neda Maghbouleh, Andrew S. Baback Boozary
  Abstract: Health Promotion Practice, Ahead of Print.
  Introduction:Equity-oriented efforts to mitigate and prevent COVID-related disparities are hindered due to methodological limitations of the categorization of racial and ethnic groups, including Arabs and Middle Eastern and North African (MENA) communities, which remain invisible in national data collection efforts. This study highlights the disparities in COVID-related outcomes in Toronto, Canada and supports ongoing calls to collect public health data among MENA communities in the United States.Methods:Data on racial/ethnic identity and hospitalizations were collected by the Toronto Public Health (TPH) of the Ontario Ministry of Public Health Case between May 20, 2020, and September 30, 2021 from people with a confirmed or probable case of COVID-19.Results:The reported COVID-19 infection rate for Arab, Middle Eastern, West Asians (i.e., categories used to self-identify as MENA in Canada) relative to Whites in Toronto was 3.51. The age-standardized hospitalization rate ratio between Arab, Middle Eastern, West Asians and Whites was 4.59.Discussion:Data from Toronto highlight that Arab, Middle Eastern, and West Asians have higher rates of COVID-19 infections and hospitalizations than their White counterparts. Comparable studies are currently not possible in the United States due to lack of data that can disaggregate MENA individuals. This study underscores the critical need to collect data among MENA communities in the United States to advance our field’s goal of promoting and advancing equity.
  Citation: Health Promotion Practice
  PubDate: 2023-01-10T06:59:31Z
  DOI: 10.1177/15248399221142898
Implementation and Process Evaluation of Alcohol Free for 40:
Community-Based Programming to Reduce Alcohol Consumption
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  Authors: Jala Lockhart, Megan B. Knapp, Amy K. Feehan, Savanna Latimer, Anna Walter, Brittany N. Craft, Yvette P. Quantz, Hope Frugé, Maria Sylvester Terry, Erin E. Arceneaux, Molly Kimball
  Abstract: Health Promotion Practice, Ahead of Print.
  Alcohol consumption is known to increase risk for chronic diseases and other negative health outcomes. Abstinence, even temporary, from alcohol consumption can have positive health impacts. In this article, we describe implementation and process evaluation of Ochsner Eat Fit’s Alcohol Free for 40 (AFF40), an annual, 40-day voluntary alcohol abstinence challenge that takes place in six regions of Louisiana. Participants are challenged to abstain from alcohol consumption for 40 days to promote behavior change. To support participants’ success, staff conduct pre and post metrics (physical and laboratory) and host community-based events to encourage replacement behaviors. Process evaluation included measures of reach, recruitment, dose, and fidelity through tracking of participant registrations, an exit survey, media analytics, and program activity logs. In 2021, 493 participants enrolled in AFF40, with 347 completing laboratory metrics and 298 completing physical metrics. Majority of exit survey respondents (74.5%) reported no alcohol consumption during the 40-day challenge and that they planned to participate in AFF40 2022 (90.9%). The Eat Fit team documented moderate engagement (48.7% of enrolled participants) in program events. Social and digital impressions and page views recorded 23,591 hits while print media resulted in over 750,000 impressions. AFF40 has shown to be highly engaging for participants and effective in supporting temporary abstinence from alcohol. Incorporating stronger methods and evaluation will enhance future program implementation and community impact. Lessons learned and implications for practice are transferable to other community-based efforts to reduce alcohol consumption.
  Citation: Health Promotion Practice
  PubDate: 2023-01-05T06:50:26Z
  DOI: 10.1177/15248399221142633